Mesenteric Venulitis: A Rare Etiology of Hematochezia and “Colitis” with Distinctive Colon Pathology
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Isolated intestinal vasculitis in the absence of systemic vasculitis can cause ischemia and gastrointestinal bleeding. Mesenteric inflammatory veno-occlusive disease has been reported as a rare cause of intestinal ischemia and GI bleeding. The ischemia mainly affects the right colon and terminal ileum . It may present as a precursor of idiopathic myointimal hyperplasia of the mesenteric veins . This particular entity has also been interpreted as or termed intramural mesenteric venulitis . We report on a case of right and left colonic involvement causing severe necrosis and diffuse GI bleeding throughout the colon. The cause of necrosis and sloughing of colonic mucosa was found to be secondary to intramural mesenteric venulitis, with lymphocytic infiltration and myointimal hyperplasia of the venules of both the superior and the inferior mesenteric veins.
KeywordsMesenteric venulitis Perivenular myointimal hyperplasia Hematochezia Venulitis Colon
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