CASE REPORT article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1637720
A Rare Case of Abdominal Pain and Hematochezia: Case Report and Literature Review
Provisionally accepted
- 1Moffitt Cancer Center, Tampa, United States
- 2China-Japan Friendship Hospital, Beijing, China
- 3Zhengzhou University College of Medicine, Zhengzhou, China
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Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare, non-thrombotic, non-inflammatory cause of chronic colonic ischemia, often misdiagnosed as inflammatory bowel disease (IBD) or ischemic colitis due to overlapping clinical features. We present the case of a 65-year-old man with progressive abdominal pain and hematochezia, initially treated as ischemic colitis without improvement. Surgical resection was eventually performed, and definitive diagnosis of IMHMV was established through histopathological evaluation, which revealed characteristic intimal smooth muscle proliferation in mesenteric veins. This report reviews the diagnostic challenges, histologic features, and clinical relevance of IMHMV, emphasizing the importance of early recognition and consideration of this entity in refractory colonic ischemia. Routine use of vascular imaging may help distinguish IMHMV from occult mesenteric arteriovenous malformations.
Keywords: Idiopathic myointimal hyperplasia, Mesenteric Veins, Abdominal Pain, Hematochezia, Colonic ischemia, case report, Misdiagnosis
Received: 29 May 2025; Accepted: 10 Oct 2025.
Copyright: © 2025 Chen, Guo, Ling, Shi, Zhang, Cheng, Wang and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianan Chen, jianan.chen@moffitt.org
Shiyu Du, dushiyu1975@sohu.com
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