Jin X, Xu TM, Ruan GC, Zhang XF, Chen XY, Li XQ, Tang H, Xu H, Wang QP, Liu W, Li J. Clinical manifestations and imaging features of inferior mesenteric vein-related colon ischemia. World J Gastroenterol 2026; 32(18): 116229 [DOI: 10.3748/wjg.v32.i18.116229]
Corresponding Author of This Article
Ji Li, MD, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. liji0235@pumch.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
May 14, 2026 (publication date) through May 6, 2026
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Journal Information of This Article
Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Jin X, Xu TM, Ruan GC, Zhang XF, Chen XY, Li XQ, Tang H, Xu H, Wang QP, Liu W, Li J. Clinical manifestations and imaging features of inferior mesenteric vein-related colon ischemia. World J Gastroenterol 2026; 32(18): 116229 [DOI: 10.3748/wjg.v32.i18.116229]
Xin Jin, Tian-Ming Xu, Ge-Chong Ruan, Xing-Fang Zhang, Xue-Yan Chen, Xiao-Qing Li, Hao Tang, Hui Xu, Qi-Pu Wang, Ji Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Wei Liu, Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Co-corresponding authors: Wei Liu and Ji Li.
Author contributions: Jin X conducted the data collection, statistical analyses, and manuscript drafting; Xu TM, Ruan GC, Zhang XF, Chen XY, Li XQ, Tang H, Xu H, and Wang QP assisted with clinical data acquisition and editing the manuscript; Liu W and Li J supervised the study, made equal contributions as co-corresponding authors. All authors approved the final version to publish.
Supported by National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-D-002; and Beijing Research Ward Excellence Program, No. BRWEP2024W034010110.
Institutional review board statement: This study was approved by the Ethics Committee of Peking Union Medical College Hospital, No. I-23PJ949.
Informed consent statement: Written informed consent or oral consent was given by all patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Ji Li, MD, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. liji0235@pumch.cn
Received: November 6, 2025 Revised: January 5, 2026 Accepted: February 26, 2026 Published online: May 14, 2026 Processing time: 182 Days and 0.1 Hours
Abstract
BACKGROUND
Colon ischemia (CI) is a common disorder with heterogeneous etiology, whereas CI secondary to inferior mesenteric vein (IMV) pathology is rare and presents distinct diagnostic challenges. Delayed diagnosis and inappropriate management may worsen prognosis.
AIM
To explore the clinical characteristics of IMV-related CI and increase awareness of this rare condition.
METHODS
This retrospective case series described 11 IMV-related CI inpatients at Peking Union Medical College Hospital and summarized their clinical characteristics, imaging and endoscopic features, and prognosis. An additional cohort of 29 arterial-related CI patients was included, and univariate analyses were conducted to compare features between arterial- and IMV-related CI patients.
RESULTS
IMV-related CI patients were all male, with a median age of 44.5 (41.5-63.3) years. Tenesmus is a common symptom, occurring in 72.7% of patients. Concurrent venous thrombosis was identified in 5 patients (45.5%). On contrast-enhanced computed tomography, all patients demonstrated continuous thickening of the colonic wall. Vessel opacification defects were observed in 10 patients (90.9%), frequently accompanied by compensatory arterial enlargement (81.8%). Compared with arterial-related CI, IMV-related CI was more frequently associated with rectal involvement (90.9% vs 24.1%, P < 0.001) and luminal stenosis (81.8% vs 27.6%, P = 0.005).
CONCLUSION
IMV-related CI patients have a chronic course, thrombosis comorbidities, and predominant rectal involvement with marked stenosis. Anticoagulation constitutes a cornerstone of therapy.
Core Tip: As a rare subtype of colon ischemia (CI), inferior mesenteric vein (IMV)-related CI often presents with nonspecific symptoms that delay diagnosis. In this study, we reviewed 11 cases from our seven-year experience, highlighting the predominance of middle-aged males, chronic disease, rectal irritation, thrombotic comorbidities, and continuous involvement of the sigmoid and rectum. Identifying both direct and indirect signs of IMV lesions on computed tomography is crucial for accurate diagnosis. Comparative analysis with arterial-related CI patients revealed substantial differences, further highlighting the necessity for prompt recognition and early intervention in IMV-related CI patients.
