The medical mystery of the fatty mesentery

Abstract

An 86-year-old gentleman presented with a 3-month history of nausea, anorexia and excruciating generalised abdominal pain. He had been discharged a week earlier from another hospital. No diagnosis had been made. Clinically the patient was feverish, with a palpable, tender and poorly defined mass in his epigastrium. He had elevated inflammatory markers and deranged electrolytes. An ultrasound scan revealed thickening and hyper echogenicity of the small bowel mesentery. A CT scan was recommended; this revealed a diagnosis of mesenteric panniculitis. First described in 1924, mesenteric panniculitis is a benign inflammatory condition of the bowel mesentery. With only a handful of cases being reported in the UK, the authors thought that they had come across a rarity. This case report focuses on the aetiology, diagnosis, pathology and treatment of mesenteric panniculitis. By examining the literature, the authors also suggest that it is relatively underdiagnosed and may be more common than first thought.

Sclerosing Mesenteritis Managed Conservatively With Prednisone

“…This was the case with our patient. A similar resolution of sclerosing mesenteritis with steroid therapy is documented in the literature [11,12].…”

Sclerosing Mesenteritis and Disturbance of Glucose Metabolism: A New Relationship? A Case Series

“…SM mainly affects men in their sixth decade of life, and has a variable clinical presentation, although it is often asymptomatic [ 6 ]. The diagnosis is usually performed by computed tomography (CT) scan, although tissue biopsy may be needed for confirmation [ 7 , 8 ].…”

Sclerosing mesenteritis (panniculitis) mimicking peritoneal tuberculosis

“…To the Editor, Mesenteric panniculitis is the inflammatory form of sclerosing mesenteritis (SM), which is a rare disorder of the mesentery still underdiagnosed (1) and is characterized in pathology by the coexistence of fat necrosis, chronic inflammation, and fibrosis (2).…”