FP4.12 - Enterocolic lymphocytic phlebitis masquerading as a malignant stricture in the cecum

Abstract Introduction Enterocolic lymphocytic phlebitis (ELP) is an idiopathic form of venous inflammation which is limited to the gastrointestinal tract. It is characterised by inflammation of the veins with no involvement of the arteries. Usually, It presents with gastrointestinal symptoms such as abdominal pain, and imaging may suggest malignancy. Case history A 56-year-old woman presented with fresh blood in her stools, abdominal pain and diarrhoea. All blood tests were normal; however, she had a raised CRP of 105 mg/L (normal < 5 mg/L). CT abdomen and pelvis showed thickening in the transverse colon and intussusception of the terminal ileum into the caecum. She was treated conservatively and discharged when symptoms resolved with an outpatient colonoscopy. The colonoscopy was incomplete due to an unresolvable sigmoid loop; CT colonography showed caecal wall thickening, which was suggestive of caecal malignancy. Following the MDT discussion, the patient was booked for a right hemi-colectomy. The right hemicolectomy specimen histology showed no malignancy, and lymphocytic phlebitis of the submucosal, subserosa and mesenteric veins, but the arteries were normal; hence, a diagnosis of enterocolic lymphocytic phlebitis was made. Conclusion ELP is a rare idiopathic form of venous inflammation localised to the gastrointestinal tract, which can occasionally present similar to bowel malignancy. The diagnosis is usually confirmed with a histopathology assessment. We present this case in light of its rarity to add to the literature on this entity.