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Mesenteric inflammatory veno-occlusive disease: radiographic and histopathologic evaluation of 2 cases

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Abdominal Imaging Aims and scope

Abstract

Mesenteric inflammatory veno-occlusive disease (MIVOD) is a rare cause of inflammatory enterocolitis whose clinical and imaging presentation can be confused with mesenteric venous thrombosis and inflammatory bowel disease. We report two cases of histologically proven MIVOD in patients presenting with abdominal pain and describe potentially useful distinguishing features at contrast-enhanced CT, including prominent small pericolonic arteries and veins but a diminutive or absent inferior mesenteric vein. Alerting referring clinicians to the possibility of this diagnosis may help avoid unnecessary anticoagulation and reduce diagnostic delay. Treatment of MIVOD is surgical resection, which is typically curative.

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References

  1. Flaherty MJ, Lie JT, Haggitt RC (1994) Mesenteric inflammatory veno-occlusive disease. Am J Surg Pathol 18:779–784

    Article  CAS  PubMed  Google Scholar 

  2. Hu JC, Forshaw MJ, Thebe P, Stewart M (2005) Mesenteric inflammatory veno-occlusive disease as a cause of acute abdomen: report of five cases. Surg Today 35(11):961–964. doi:10.1007/s00595-004-3036-6

    Article  PubMed  Google Scholar 

  3. Medlicott SA, Guggisberg KA, DesCôteaux JG, Beck P (2006) Enterocolic lymphocytic phlebitis: statistical analysis of histology features in viable and ischemic bowel. Int J Surg Pathol 14(3):200–205. doi:10.1177/1066896906289995

    Article  PubMed  Google Scholar 

  4. Ngo N, Chang F (2007) Enterocolic lymphocytic phlebitis: clinicopathologic features and review of the literature. Arch Pathol Lab Med 131(7):1130–1134

    PubMed  Google Scholar 

  5. Abu-Alfa AK, Ayer U, West AB (1996) Mucosal biopsy findings and venous abnormalities in idiopathic myointimal hyperplasia of the mesenteric veins. Am J Surg Pathol 20(10):1271–1278

    Article  CAS  PubMed  Google Scholar 

  6. Chiang CK, Lee CL, Huang CS, Huang SH, Wu CH (2012) A rare cause of ischemic proctosigmoiditis: idiopathic myointimal hyperplasia of mesenteric veins. Endoscopy 44(2):E54–E55 (UCTN). doi:10.1055/s-0031-1291529

    PubMed  Google Scholar 

  7. Kao PC, Vecchio JA, Hyman NH, West AB, Blaszyk H (2005) Idiopathic myointimal hyperplasia of mesenteric veins: a rare mimic of idiopathic inflammatory bowel disease. J Clin Gastroenterol 39(8):704–708

    Article  PubMed  Google Scholar 

  8. Lavu K, Minocha A (2003) Mesenteric inflammatory veno-occlusive disorder: a rare entity mimicking inflammatory bowel disorder. Gastroenterology 125(1):236–239

    Article  PubMed  Google Scholar 

  9. Genta RM, Haggitt RC (1991) Idiopathic myointimal hyperplasia of mesenteric veins. Gastroenterology 101(2):533–539

    CAS  PubMed  Google Scholar 

  10. Saraga EP, Costa J (1989) Idiopathic entero-colic lymphocytic phlebitis. A cause of ischemic intestinal necrosis. Am J Surg Pathol 13(4):303–308

    Article  CAS  PubMed  Google Scholar 

  11. Gul A, Inanc M, Ocal L, et al. (1996) Primary antiphospholipid syndrome associated with mesenteric inflammatory veno-occlusive disease. Clin Rheumatol 15(2):207–210

    Article  CAS  PubMed  Google Scholar 

  12. Ailani RK, Simms R, Caraciono AA, West BC (1997) Extensive mesenteric inflammatory veno-occlusive disease of unknown etiology after primary cytomegalovirus infection: first case. Am J Gastroenterol 92(7):1216–1218

    CAS  PubMed  Google Scholar 

  13. Tempia-Caliera AA, Renzulli P, Z’graggen K, et al. (2002) Mesenteric inflammatory veno-occlusive disease: a rare cause of intestinal ischaemia. The first description of recurrent disease. Digestion 66:262–264

    Article  CAS  PubMed  Google Scholar 

  14. Wiesner W, Khurana B, Hoon Ji, Ros PR (2003) CT of acute bowel ischemia. Radiology 226(3):635–650. doi:10.1148/radiol.2263011540

    Article  PubMed  Google Scholar 

  15. Horton KM, Fishman EK (2010) CT angiography of the mesenteric circulation. Radiol Clin North America 48(2):331–345. doi:10.1016/j.rcl.2010.02.00

    Article  Google Scholar 

  16. Duran R, Denys AL, Letovanec I, Meuli RA, Scmidt S (2012) Multidetector CT features of mesenteric vein thrombosis. Radiographics 32(5):1503–1522. doi:10.1148/rg.325115100

    Article  PubMed  Google Scholar 

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Correspondence to Aaron C. Miracle.

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Miracle, A.C., Behr, S.C., Benhamida, J. et al. Mesenteric inflammatory veno-occlusive disease: radiographic and histopathologic evaluation of 2 cases. Abdom Imaging 39, 18–24 (2014). https://doi.org/10.1007/s00261-013-0049-x

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