Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature

Abstract

Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper.

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

“…12 If medical therapy fails or in the last phase when extensive fibrosis causes life threatening complications such as bowel obstruction or perforation; surgical intervention is mandatory. 13 At the former appendectomy operation of our patient, the affected omentum was slightly attached to the appendix, and was not removed. We usually perform a partial omentectomy at the…”

“…4 Because the omental involvement is extremely rare, the prior 3 adult patients with isolated omental panniculitis were operated because of abdominal tenderness or suspected malignant diseases. [11][12][13] In the latter reported case, Jeon et al have decided to take a CT-guided biopsy based on the CAT scan features of the mass (presence of highattenuating mesenteric fat and tumoral pseudo capsule) and treated the patient with low dose prednisolone. 10 We operated the patient because of the persistence of abdominal tenderness, vomiting and possible malignant origin.…”

“…In one of these cases the medical treatment contributed to the cause of the panniculitis, while the other three were idiopathic. [10][11][12][13] There is no consensus on the management of patients with intraabdominal panniculitis. Drug therapy is not standardized and a variety of anti-inflammatory, immunomodulatory and antifibrotic agents are used according to the stage of the disease.…”

Multiple Mesenteric Panniculitis as a Complication of Sjögren's Syndrome Leading to Ileus

“…Conservative therapy, such as bowel rest, PSL, thalidomide, cyclophosphamide, progesterone, colchicine, azathioprine, tamoxifen, antibiotics, emetine and radiotherapy, is often used (10,11). In addition, surgical resection is performed in cases in which conservative therapy results in no improvement, such as patients with severe obstructive impairment and organic lesions, including fibrosis (12). MP may be surgically treated when it is difficult to differentiate the lesion from malignancy, relapse is frequent or in cases of massive melena.…”

Spontaneous remission of sclerosing mesenteritis

“…Sclerosing mesenteritis (SM) is a rare nonspecific fibroinflammatory disorder of unknown etiology that usually affects the small bowel mesentery (1)(2)(3)(4). It is now considered as a single disease with two pathological subgroups.…”