Idiopathic Myointimal Hyperplasia of the Mesenteric Veins

A 65-year-old man with no significant past medical history was admitted to an outside hospital with 1.5 months of crampy, lower abdominal pain associated with rectal urgency and tenesmus. Initial computed tomography showed thickening of his rectosigmoid and mid to distal descending colon; follow-up colonoscopy revealed inflammation of the affected areas with focal lamina propria vascular congestion and sloughing epithelium in the rectosigmoid colon. A course of antibiotics followed by a course of oral steroids did not improve his symptoms.