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Mesenteric inflammatory veno-occlusive disease of the colon: An under-recognized entity


1 Department of Histopathology, Apollo Hospitals, Chennai, Tamil Nadu, India
2 Department of Gastroenterology, Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India

Correspondence Address:
Saloni Naresh Shah,
Department of Histopathology and Cytology, 21 Greams lane, Off Greams road, Thousand lights, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_85_22

Isolated nonthrombotic venulitis of the colon with concomitant ischemic injury, also known as mesenteric inflammatory veno-occlusive disease (MIVOD), is a rare inflammatory vascular disorder of unknown etiology. First described in 1994, there are only about 34 cases in the literature. We report a 25-year-old woman who presented with loose stools and abdominal pain of 3-week duration. Investigations revealed eosinophilia. Endoscopy showed erosion and ulcers of the gastrointestinal tract, with mucosal biopsies showing features of ischemic injury. Computed tomography showed an edematous and thickened colonic wall with impending perforation, hence, a subtotal colectomy was performed. The patient, however, had a cardiac arrest and expired despite adequate measures. The resection specimen was consistent with a diagnosis of MIVOD. As the clinical and radiological features of MIVOD are nonspecific and overlap with inflammatory bowel disease or mesenteric ischemic disorders, histopathological examination of the resection specimen is the mainstay for its diagnosis. We believe this is the only other case in the literature of MIVOD with eosinophil predominance.


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    -  Shah SN
    -  Bhayani P
    -  Parameswaran SA
    -  Parameswaran A
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