A Case of Mesenteric Panniculitis Associated With Large Amounts of Chylous Ascites

Mizutani, Kazuki; Konishi, Jiro; Hayashida, Ryozo; Nishimura, Yutaka; Yoshimori, Kenichi; Shirouzu, Kazuo

doi:10.3919/jjsa.64.902

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…Regarding ascites in MP, two English papers reported chylous ascites, the frequency of which was 14% (13/92) and 18.5% (5/27), respectively [ 1 , 11 ]. Although the amount was usually small [ 1 ], massive chylous ascites was reported in several cases, most of which were Japanese [ 13 – 18 ]. Mechanism of the chylous ascites was believed to be direct mechanical compression by the mesenteric mass encasing the bowel, blood vessels, and lymphatics that resulted in abdominal pain, bowel obstruction, ischemia, and chylous ascites [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…And yet it is more common in the small bowel (69%) than in the large bowel mesentery (22.6%) in the Unites States [ 4 ]. The small bowel mesentery was involved in all the cases with massive chylous ascites [ 13 – 18 ]. Other types of ascites seem to be very rare without the complications, including bowel perforation, ischemic change, cardiogenic shock, and secondary infection [ 22 , 23 , 27 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…In rare occasions, a patient may present with ascites, usually of the chylous type [ 1 , 11 ]. The report of MP with massive ascites is rare [ 13 – 18 ]. The report of MP with massive chylous pleural effusion (CPE) or chylothorax is extremely rare [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions

et al. 2018

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Patient: Female, 81Final Diagnosis: Suspicious of mesenteric panniculitisSymptoms: Dyspnea • edemaMedication: —Clinical Procedure: DiureticsSpecialty: Gastroenterology and HepatologyObjective:Rare diseaseBackground:Mesenteric panniculitis (MP) is an idiopathic chronic inflammatory condition of the mesentery. The main symptoms include abdominal pain, abdominal distention, weight loss, fever, nausea, and vomiting. The patients also present with chylous ascites in 14% of the cases and chylous pleural effusion (CPE) in very rare occasions. Despite the previous view of excellent prognosis of MP, two recent papers reported several fatal cases. However, there are still only a few autopsy case reports that describe the macroscopic and histological details of MP cases.Case Report:The patient was an 81-year-old Japanese woman. She complained of edema of her lower legs and face, general fatigue, and dyspnea. She was overweight and had type 2 diabetes (T2D). Computerized tomography (CT) demonstrated massive bilateral pleural effusions, with mild pericardial effusion and mild ascites. There was no pulmonary, cardiac or hepatic condition to explain the effusions. However, MP was suspected based on her CT. She gradually deteriorated into respiratory failure. The autopsy revealed CPEs (left 1,300 mL, right 1,400 mL) and MP in the mesentery of the small intestine. Neither neoplasia nor inflammatory conditions other than MP were detected.Conclusions:In rare occasions, patients with MP present with CPE or chylothorax. We thought that a possible mechanism of the CPEs was a diaphragmatic defect. We suspected that being overweight and T2D had an etiological relationship with MP in our patient’s case. Adipose tissue of the mesentery is the main focus of MP. We believed that MP would be the best umbrella term of the many synonyms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions

et al. 2018

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“…had large bowel mesentery involvement (11). The authors also found that the sigmoid mesentery was most frequently involved among the large bowel mesentery (11).…”

Section: Figure 5 the Microscopic Findings Showed Fat Necrosis With mentioning

confidence: 90%

“…The authors also found that the sigmoid mesentery was most frequently involved among the large bowel mesentery (11). Therefore, the portion of the mesentery most frequently involved in sclerosing mesenteritis appears to differ between races.…”

Section: Figure 5 the Microscopic Findings Showed Fat Necrosis With mentioning

confidence: 92%

Refractory Sclerosing Mesenteritis Involving the Small Intestinal Mesentery: A Case Report and Literature Review

et al. 2014

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A 28-year-old Japanese man presented with upper abdominal pain. Computed tomography (CT) revealed a soft tissue mass in the small bowel mesentery. We diagnosed the patient with sclerosing mesenteritis according to the histological findings of small bowel mesentery. Although he was treated with prednisolone, colchicine and azathioprine, neither his symptoms nor CT findings improved. This case is rare in that the disease was refractory. The characteristics of Japanese patients with sclerosing mesenteritis involving small bowel mesentery are not well understood. We herein describe the details of such patients based on a literature review including 32 recently reported Japanese cases.

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