Mesenteric panniculitis in a child misdiagnosed as appendicular mass: a case report and review of literature

Rumman, Nisreen; Rumman, George; Sharabati, Barakat; Zagha, Rami; Disi, Nimer

doi:10.1186/2193-1801-3-73

Cited by 8 publications

(10 citation statements)

References 47 publications

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“…Similar to adults, the most common finding in children is abdominal pain, sometimes presenting as acute abdomen, leading to surgical intervention. 2,[21][22][23] Two of the cases in this paper presented with signs and symptoms of acute abdomen, one of them had a preliminary diagnoses of appendicitis resulting in surgical intervention the other patient received an explorative laparotomy.…”

Section: Discussionmentioning

confidence: 94%

“…20 It is usually benign, but intestinal obstruction, perforation, pneumoperitoneum, ischemic colitis, chylous acid, vascular thrombosis, recurrent pleural effusion, biliary and pancreatic fistula are reported complications. 21 Because of this wide variety and non-specific clinical features, mesenteric panniculitis should be in the differential diagnosis of chronic abdominal pain in cases where common causes are excluded. Physical examination, laboratory and imaging investigation may not be sufficient alone for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…There are two characteristic features; "Sign of fat ring" and "tumoral pseudocapsule". 21,25 However, CT findings are mostly non-specific and may require further evaluation with explorative laparotomy in pediatric patients. 24 The exact diagnosis is confirmed by histopathological examination.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric mesenteric panniculitis: three cases and a review of the literature

et al. 2019

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Mesenteric panniculitis is an inflammatory and fibrotic process in the mesenteric adipose tissue with unknown etiology. It is rarely seen in general, particularly in children. Etiology is unknown, and pathophysiology is not clear. Factors that trigger the disease are malignancy, tuberculosis, trauma, medications and past surgical interventions. There is no pediatric case series in the literature except single case reports. This paper consists of 3 cases: The first case is a 5-month-old girl, the youngest patient in the literature, who was referred to a pediatric surgeon with vomiting and abdominal distention. She had diffused intraabdominal fluid and mesenteric panniculitis documented by perioperative biopsy. The second case had acute abdominal pain with perforated appendicitis, who eventually had mesenteric panniculitis in the evaluation of the pathological specimen. The last case had a diagnosis of polyarticular juvenile idiopathic arthritis (JIA), successfully treated with etanercept, and has been in remission for 2 years. Interestingly, in one of her routine visits, she had pallor, anemia and renal failure. Bilateral hydronephrosis was detected. Magnetic resonance imaging (MRI) of the abdomen revealed retroperitoneal fibrosis, and mesenteric panniculitis was the histopathological diagnosis.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Pediatric mesenteric panniculitis: three cases and a review of the literature

et al. 2019

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“…n In up to 90% of cases, intraabdominal panniculitis involves the small bowel mesentery or sigmoid mesentery (mesenteric panniculitis), but on rare occasions, the region of involvement is the mesocolon, omentum, retroperitoneum or pelvis. 5 Mesenteric panniculitis is a progressive disease and has three typical grades according to histological grading: mesenteric lipodystrophy ( w h e n f a t t y d e g e n e r a t i o n a n d n e c r o s i s are predominant), mesenteric panniculitis (subsequent marked inflammatory reaction), retractile mesenteritis or mesenteric fibrosis (fibrosis of the adipose tissue). 5 M e s e n t e r i c p a n n i c u l i t i s i s u s u a l l y a s y m p t o m a t i c a n d o f t e n i n c i d e n t a l .…”

Section: Figure 3: Histopathologic Examinationmentioning

confidence: 99%

“…5 Mesenteric panniculitis is a progressive disease and has three typical grades according to histological grading: mesenteric lipodystrophy ( w h e n f a t t y d e g e n e r a t i o n a n d n e c r o s i s are predominant), mesenteric panniculitis (subsequent marked inflammatory reaction), retractile mesenteritis or mesenteric fibrosis (fibrosis of the adipose tissue). 5 M e s e n t e r i c p a n n i c u l i t i s i s u s u a l l y a s y m p t o m a t i c a n d o f t e n i n c i d e n t a l . Daskalogiannaki et al reported an incidence of 0.6% of mesenteric panniculitis among 7620 patients on CAT scan evaluation.…”

Section: Figure 3: Histopathologic Examinationmentioning

confidence: 99%

Isolated omental panniculitis in a child with abdominal pain. Case report

et al. 2016

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Isolated omental panniculitis is a rare entity mostly seen in adults. It presents with the inflammation of the fatty tissue of the omentum. The symptoms may vary from local (e.g. abdominal tenderness or palpable mass) to systemic manifestations including abdominal pain, back pain, fever, weight loss and bowel disturbances. We presented this case as a first awareness of omental panniculitis in a child which must be kept in mind at the differential diagnosis of ileus so that unnecessary surgeries might be avoided.

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Mesenteric Panniculitis (MP) in CT – A Predictor of Malignancy?

Scheer

Spunar²,

Wiggermann

et al. 2016

Fortschr Röntgenstr

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▼Purpose: The exact etiology of mesenteric panniculitis (MP) is still unknown and has been discussed in relation to different causes. The aim of this retrospective study was to evaluate a coherence between MP and malignancy. Materials and Methods: Retrospective analysis of consecutive CT abdomen examinations of 5595 patients in terms of MP over a period of 3 years was performed. To make the diagnosis of MP, three of five typical signs were obligatory: hyperdense mass lesion with intercalated nodules, a "fat-ring sign" or halo sign, a hyperdense pseudocapsule and displacement of bowel loops. The patient cohort (mean age: 64.7 years) consisted of 1974 (35.2 %) patients with histologically confirmed cancer and 3621 patients (64.8 %) without known underlying oncological disease. Results: A total of 143 cases were diagnosed with MP (2.55 %). The average age of patients was 69.9 years with a male to female ratio of 2:1. In this group oncological disease was confirmed in 107 patients (74.8 %). In 36 patients with MP (25.2 %), no malignancy was present. In the group of patients with an underlying oncological disease, the prevalence of MP was 5.42 % and was significantly higher (p < 0.005) than in the patients with MP and without an oncological disease. The highest prevalence of MP (29 cases) was observed in non-Hodgkin lymphoma (22.6 %). The statistically calculated risk of a tumor disease in this collective is about 5 times higher if MP was demonstrated (p < 0.001). Conclusion: Based on the data of the collective, the risk of malignancy is five times higher in the presence of MP than in an inconspicuous mesentery. MP seems to frequently occur with non-Hodgkin lymphoma. MP can be seen on the basis of typical morphological features on the CT image. MP must be differentiated from a wide range of benign and malignant diseases of the mesentery.

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Mesenteric panniculitis in a child misdiagnosed as appendicular mass: a case report and review of literature

Cited by 8 publications

References 47 publications

Pediatric mesenteric panniculitis: three cases and a review of the literature

Pediatric mesenteric panniculitis: three cases and a review of the literature

Isolated omental panniculitis in a child with abdominal pain. Case report

Mesenteric Panniculitis (MP) in CT – A Predictor of Malignancy?

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