ALIMENTARY TRACT: Case ReportIdiopathic Myointimal Hyperplasia of the Mesenteric Veins Diagnosed PreoperativelyWangensteen, Kirk J. MD, PhD*; Fogt, Franz MD, Dr Med†; Kann, Brian R. MD‡; Osterman, Mark T. MD, MSCE* Author Information Departments of *Medicine †Pathology and Laboratory Medicine ‡Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA K.J.W. was supported by the NIH/NIDDK grant T32DK007066 The authors declare that they have nothing to disclose. Reprints: Mark T. Osterman, MD, MSCE, Penn Presbyterian Medical Center, Division of Gastroenterology, 218 Wright Saunders Building, 51N. 39th Street, Philadelphia, PA 19104 (e-mail: [email protected]). Journal of Clinical Gastroenterology: July 2015 - Volume 49 - Issue 6 - p 491-494 doi: 10.1097/MCG.0000000000000290 Buy Metrics Abstract Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) of the colon is a very rare disease that in previously reported cases was often mistaken for inflammatory bowel disease because of similar clinical characteristics. In our review of the literature, we found a total of 15 cases described, generally featuring sigmoid and rectal colitis and symptoms of abdominal pain, diarrhea, and hematochezia refractory to treatment with immunosuppressants. In all previously reported cases, the diagnosis was achieved only after surgical resection of the affected area. Herein, we report a case of IMHMV that was diagnosed preoperatively based on clinical information and endoscopy with biopsies. This led to the withdrawal of immunosuppression before a carefully planned surgical resection, with confirmation of the diagnosis in the resected tissue. To our knowledge, our case of IMHMV is the first to be diagnosed preoperatively. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.