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European Journal of Vascular and... Apr 2017
Review
Topics: Endovascular Procedures; Humans; Mesenteric Arteries; Mesenteric Veins; Predictive Value of Tests; Risk Factors; Splanchnic Circulation; Treatment Outcome; Vascular Diseases; Vascular Surgical Procedures
PubMed: 28359440
DOI: 10.1016/j.ejvs.2017.01.010 -
Surgery Sep 2023Idiopathic myointimal hyperplasia of the mesenteric veins is an extremely rare non-thrombotic mesenteric veno-occlusive disease. The management of idiopathic myointimal... (Review)
Review
BACKGROUND
Idiopathic myointimal hyperplasia of the mesenteric veins is an extremely rare non-thrombotic mesenteric veno-occlusive disease. The management of idiopathic myointimal hyperplasia of the mesenteric veins is not well-established, and although surgery is the mainstay of treatment, the optimal operation remains unclear. Therefore, we aimed to perform a systematic review to assess the various surgical procedures and associated outcomes for patients with idiopathic myointimal hyperplasia of the mesenteric veins.
METHODS
A systematic search for articles published from 1946 to April 2022 in MEDLINE, EMBASE, Cinahl, Scopus, Web of Science, and Cochrane Library databases is reported. In addition, we report 4 cases of idiopathic myointimal hyperplasia of the mesenteric veins managed at our institution until March 2023.
RESULTS
A total of 53 studies and 88 patients with idiopathic myointimal hyperplasia of the mesenteric veins were included. Most (82%) were male patients, with a mean age of 56.6 years old. The majority (99%) of patients required surgery. Most reports described the involvement of the rectum and sigmoid colon (81%). The most common surgical procedures were Hartmann's procedure (24%) and segmental colectomy (19%); completion proctectomy with ileal pouch-anal anastomosis was performed in 3 (3.4%) cases. In 6 (6.8%) cases, idiopathic myointimal hyperplasia of the mesenteric veins was suspected preoperatively and managed with elective surgery. Four (4.5%) complications were reported. Nearly all (99%) patients achieved remission with surgical intervention.
CONCLUSION
Idiopathic myointimal hyperplasia of the mesenteric veins is a rare pathologic entity infrequently suspected preoperatively and typically diagnosed after surgical resection. Surgical resection with Hartmann's procedure or segmental colectomy was most commonly performed, with completion proctectomy and ileal pouch-anal anastomosis reserved for cases of extensive rectal involvement. Surgical resection was safe and effective, with a low risk of complications and recurrence. Surgical decision-making should be based on the extent of the disease at the time of presentation.
Topics: Humans; Male; Middle Aged; Female; Hyperplasia; Mesenteric Veins; Colon, Sigmoid; Vascular Diseases; Colectomy
PubMed: 37301609
DOI: 10.1016/j.surg.2023.04.014 -
Journal of Gastroenterology and... Jul 2023Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is an uncommon cause of colonic ischemia for which surgical treatment is typically curative. We... (Review)
Review
BACKGROUND AND AIM
Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is an uncommon cause of colonic ischemia for which surgical treatment is typically curative. We describe clinical, radiologic, and endoscopic findings in IMHMV patients to provide clinicians with a framework for pre-surgical identification of this rare disease.
METHODS
We performed a systematic review of seven databases for IMHMV cases and identified additional cases from Yale New Haven Hospital records. To identify features specifically associated with colonic ischemia due to IMHMV, we performed multivariate logistic regression analysis incorporating data from a large cohort of patients with biopsy-proven ischemic colitis.
RESULTS
A total of 124 patients with IMHMV were identified (80% male, mean age 53 years, 56% Caucasian). Presenting symptoms were most commonly abdominal pain (86%) and diarrhea (68%). The most affected areas were the sigmoid colon (91%) and rectum (61%). Complications associated with diagnostic delay occurred in 29% of patients. Radiologic vascular abnormalities including non-opacification of the inferior mesenteric vein were observed in 35% of patients. Of the patients, 97% underwent curative surgical resection. Compared with non-IMHMV colonic ischemia, IMHMV was significantly associated with younger age, male sex, absence of rectal bleeding on presentation, rectal involvement, and mucosal ulcerations on endoscopy.
CONCLUSION
IMHMV is a rare, underreported cause of colonic ischemia that predominantly involves the rectosigmoid. Our findings suggest younger age, rectal involvement, and absence of rectal bleeding as clinical features to help identify select patients presenting with colonic ischemia as having higher likelihood of IMHMV and therefore consideration of upfront surgical management.
Topics: Humans; Male; Middle Aged; Female; Hyperplasia; Mesenteric Veins; Delayed Diagnosis; Colitis, Ischemic; Ischemia
PubMed: 37086041
DOI: 10.1111/jgh.16193 -
Korean Journal of Radiology Dec 2023
Topics: Humans; Mesenteric Veins; Hyperplasia; Biopsy
PubMed: 38016688
DOI: 10.3348/kjr.2023.0782 -
Clinical Gastroenterology and... Sep 2020
Topics: Biopsy; Colon; Humans; Hyperplasia; Mesenteric Veins
PubMed: 31336197
DOI: 10.1016/j.cgh.2019.07.030 -
Gastroenterology Jun 2022
Topics: Colon; Humans; Hyperplasia; Mesenteric Veins
PubMed: 35247456
DOI: 10.1053/j.gastro.2022.02.046 -
Idiopathic myointimal hyperplasia of the mesenteric veins, an uncommon cause of intestinal ischemia.Revista Espanola de Enfermedades... Jun 2022Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is an uncommon cause of intestinal ischemia. It was firstly described by Genta and Haggit in 1991. Only...
Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is an uncommon cause of intestinal ischemia. It was firstly described by Genta and Haggit in 1991. Only a few cases have been reported and it is difficult to know the true incidence.
Topics: Humans; Hyperplasia; Ischemia; Mesenteric Veins
PubMed: 35100804
DOI: 10.17235/reed.2022.8654/2022 -
Inflammatory Bowel Diseases Sep 2022
Topics: Colon; Humans; Hyperplasia; Mesenteric Veins
PubMed: 35639934
DOI: 10.1093/ibd/izac113 -
Internal Medicine (Tokyo, Japan) 2008
Topics: Calcinosis; Colon; Female; Humans; Mesenteric Veins; Middle Aged; Peripheral Vascular Diseases; Radiography; Sclerosis
PubMed: 18239331
DOI: 10.2169/internalmedicine.47.0479 -
Clinical Radiology Jul 2014Acute conditions affecting the mesenteric vessels can cause abdominal pain and result in significant morbidity and mortality if not diagnosed and treated quickly. As... (Review)
Review
Acute conditions affecting the mesenteric vessels can cause abdominal pain and result in significant morbidity and mortality if not diagnosed and treated quickly. As bowel viability depends on patency of the mesenteric vessels, prompt diagnosis is essential. Helical multidetector computed tomography (MDCT) provides a rapid, widely available, non-invasive method to promptly evaluate the mesenteric arteries, veins, and abdominopelvic viscera. Given the value of MDCT in diagnosing vascular disease, it is important the radiologist understand technical and imaging findings of mesenteric vascular injury. Therefore, successful diagnosis hinges on familiarity with MDCT angiography and the extended capabilities of volume rendering and multiplanar reformation. In this review, we illustrate and describe key MDCT findings of congenital, inflammatory, traumatic, infectious, and thromboembolic conditions affecting the mesenteric vasculature in adult patients.
Topics: Acute Disease; Aneurysm, Infected; Humans; Mesenteric Arteries; Mesenteric Veins; Mesentery; Multidetector Computed Tomography; Thromboembolism; Vascular Diseases; Vasculitis
PubMed: 24824975
DOI: 10.1016/j.crad.2013.12.020