Mesenteric venulitis in a 71-year-old man after acute appendicitis.
Mesenteric inflammatory veno-occlusive disease (MIVOD) is a clinicopathological entity recently described for a case series of patients with intestinal ischemia of unknown etiology. MIVOD is characterized as a venulitis with lymphocytic, necrotizing, or mixed granulomatous morphology. The disease seems to be self-limiting with resolution of symptoms after surgical resection. We describe a 71-year-old man who developed focal intestinal ischemia in the postoperative period after laparoscopic appendectomy. At re-exploration, a 20-cm segment of grossly ischemic jejunum was identified and resected. The excised specimen demonstrated early ischemic mucosal injury and necrotizing mesenteric venulitis with thrombosis, consistent with verso-occlusive disease. The etiology of this rare vasculitis is currently unknown. We present our case report, which is followed by a review of the literature of MIVOD.
Charron
Paul
P
Orlando Regional Healthcare, Orlando, Florida, USA.
Smith
Jeff
J
D000208:Acute Disease; D000368:Aged; D000714:Anastomosis, Surgical; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D001707:Biopsy, Needle; D017091:Colitis, Ischemic / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome