Paniculitis mesentérica

Abstract

Mesenteric panniculitis is a condition characterized by chronic nonspecific inflammation of the mesentery. There is little and often confusing information about its characteristics and the approach to take once it has been demonstrated by an imaging test. We propose to describe the epidemiological, clinical, laboratory, radiological and pathological features of the patients with mesenteric panniculitis reported in the literature, as well as possible disorders causal or associated with mesenteric panniculitis, in the opinion of the authors of each study. Finally, we will review the different therapeutic options used and the response to them. To that end a literature search was performed from the main medical databases selecting ítems with information on these aspects. This information was collected on a database stored in SPSS software for further analysis and summary.

Mesenteric panniculitis: diagnostic precision

“…The imaging findings of MP are not specific and reflect the existence of an inflammatory process of the mesenterium that occurs both on inflammation and tumorous pathologies. [2][3][4][5][6][7] Moreover, MP has also been reported in association with systemic vasculitis such as Henoch-Schönlein purpura. 9 The imaging findings to the diagnosis of MP is based on typical CT features that include a mass effect of neighbouring gastrointestinal structures, a mesenteric slightly heterogenous well-circumscribed fatty proliferation surrounded by a peripheral capsule and internal small soft tissue nodules surrounded by a hypoattenuating halo.…”

“…[1][2][3][4] Definitive treatment for MP is still controversial in the medical literature with both medical and surgical approaches referred. For medical treatment, prednisolone, azathioprine, tamoxifen, thalidomide, antibiotics, infliximab and cyclophosphamide have been studied as acceptable options.…”

“…1 MP is an idiopathic disease but it has been associated with cancers, intra-abdominal surgery, ischaemic heart disease or autoimmune disorders on scientific literature. [1][2][3][4] The clinical presentation of the patients is diverse, but more frequently they present with abdominal pain, weight loss, fever, nausea and vomiting. The diagnosis is histopathological.…”

Secondary Mesenteric Panniculitis as a Paraneoplastic Syndrome: An Updated Review

“…The disease has been called "mesenteric sclerosis" when the dominant feature is fibrosis, "mesenteric panniculitis" when it is inflammation, and "mesenteric lipodystrophy" when it is fat necrosis. Other terms used in the medical literature include: retractile mesenteritis, sclerosing mesenteritis, xanthogranulomatous mesenteritis, mesenteric lipogranuloma, liposclerotic mesenteritis, isolated lipodystrophy, and retroperitoneal xantogranulomatosis [1]. First described by Jura et al in 1924 [2] as retractile mesenteritis, only in 1965 did Ogden et al [3] coin the term mesenteric panniculitis.…”

“…The epidemiology is somewhat uncertain, with reported prevalence ranging from 0.16% to 7.83% due to the variability of the criteria used [1]. The disease presents most frequently in white men (ratio men: women 2:1) [4,1], and its appearance increases with age (mean age 62 years) [1]. The rising use of imaging techniques has also positively impacted the number of cases described.…”