vv Archives of Clinical Gastroenterology ISSN: 2455-2283 DOI CC By 074 Citation: Rama Kumari B, Ahluwalia J, Vaiphei K (2017) Myointimal hyperplasia of mesenteric vein- an experience in a tertiary care centre. Arch Clin Gastroenterol 3(3): 074-079. DOI: http://doi.org/10.17352/2455-2283.000044 Clinical Group Abstract Background: Idiopathic myointimal hyperplasia of mesenteric vein (IMHMV) is an extremely rare cause of venous mesenteric ischemia. It is defined as non-thrombotic occlusion of the mesenteric veins secondary to myointimal hyperplasia. IMHMV is a poorly understood condition involving the rectosigmoid colon predominantly young previously healthy male individuals Purpose - to analyze surgically resected bowel specimens reported routinely as intestinal ischemia for the presence of features of IMHMV. There were 30 IMHMV of 118 cases that had been reported as intestinal ischemia. Results: Clinical and laboratory findings in these 30 cases were re-evaluated. Mean age was 41.83±21.67 years and male female ratio was 5:1. Common presenting symptoms were abdominal pain (93.3%), diarrhoea (70%) and rectal bleeding (40%). Left colon was commonest site of involvement followed by right colon and ileum. Unique histological features observed were variable grades of fibrosis with subserosal and submucosal small to medium size veins showing myointimal proliferation. Thirteen of these 30 patients had associated intestinal stress conditions like strictures, torsions, volvulus and intussusceptions. Majority of these patients were investigated further for hypercoagulable states and were documented to be negative. Conclusion: IMHMV is a selflimited condition where surgical resection of the affected segment is sufficient for a definitive treatment and needs to be recognized to avoid further unwarranted “management”. Research Article Myointimal hyperplasia of mesenteric vein- an experience in a tertiary care centre Rama Kumari Badyal, Jasmina Ahluwalia* and Kim Vaiphei Departments of Histopathology and Hematology*, Postgraduate Institute of Medical Sciences and Research, Chandigarh, India Dates: Received: 01 August, 2017; Accepted: 01 September, 2017; Published: 04 September, 2017 *Corresponding authors: Kim Vaiphei, Profes- sor, Department of Histopathology, Anand Block, Postgraduate Institute of Medical Sciences and Research, Chandigarh, India, Pin – 160012, Tel: +91 9815912943; Fax: 0172 2744401; Email: Keywords: myointimal hyperplasia; Mesenteric veins; Intestinal ischemia; Inflammatory bowel disease; Colitis; Tuberculosis; ymphoma https://www.peertechz.com Abbreviations IMHMV: Idiopathic Myointimal Hyperplasia Of Mesenteric Vein; IBD: Inflammatory Bowel Disease; MIVOD: Mesenteric Inflammatory Veno-Occlusive Disorder; EVG: Elastica Van Giesen; MT: Masson’s Trichrome; IHC: Immunohistochemistry; SMA: Smooth Muscle Actin; PT: Prothrombin Time; APTT: Activated Partial Thromboplastin Time; PC: Protein C; PS: Protein S; ATIII: Anti-Thrombin III; FVL: Factor V Leiden Mutation; ACA: Anti-Cardiolipin Antibody; CECT: Contrast Enhanced Computed Tomography; IPSID: Immunoproliferative Small Intestinal Disease Background Idiopathic myointimal hyperplasia of mesenteric vein (IMHMV) is a rare disease described by Genta and Haggitt in 1991 [1]. It is a poorly understood disease frequently involving rectosigmoid usually in healthy young males. Often it is mistaken for inflammatory bowel disease (IBD) or mesenteric inflammatory veno-occlusive disorder (MIVOD) [2]. IMHMV usually presents with rectal bleeding or bloody stool resembling IBD. The diagnosis is established at histopathological examination of the surgical resected specimen in which the veins show intimal smooth muscle proliferation with normal accompanying arteries. IMHMV has been described mainly in the territory of inferior mesenteric venous drainage [3]. It has a benign clinical course and does not relapse after surgical resection of the affected intestinal segment [4]. Incidence of IMHMV is not known, likely to be under recognized and is important to differentiate from other conditions like IBD and intestinal tuberculosis. The present study was undertaken to determine prevalence of IMHMV in a tertiary care centre in surgical resected specimens retrospectively in cases that had been reported as ischemic enterocolitis, and to evaluate clinical profiles and laboratory parameters.