The Prevalence of Incidentally Detected Idiopathic Misty Mesentery on Multidetector Computed Tomography: Can Obesity be the Triggering Cause?

Ünlü, Ebru; Okur, Nazan; Acay, Mehtap Beker; Kaçar, Emre; Özdinç, Şerife; Balçık, Çınar; Tokgöz, Özlem

doi:10.1016/j.carj.2015.06.004

Cited by 6 publications

(7 citation statements)

References 21 publications

(58 reference statements)

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“…Although the patients with MM were significantly older than those without in our study, mean age was 45.2±12.2 years, younger than age group of SM. Our data and study of Unlu et al 19 are alike regarding mean age of these patients. Since SM is associated with many diseases and risk factors, different diseases might effect different age groups in SM.…”

Section: Discussionsupporting

confidence: 71%

“…In their study, Canyigit et al 20 suggested that nonspecific chronic inflammatory reaction in SM is triggered by independent factors that cause disturbances of proinflammatory and anti-inflammatory cytokines in mesenteric fat. We suggest that urine in perinephric and pararenal spaces may incite an inflammatory response by adipocytes causing SM-like changes in intraabdominal adipose tissue as defined in the previous study regarding obesity and MM 19 . We believe this might be pathogenetic mechanism for the cause of MM in patients with ureterolithiasis.…”

Section: Discussionsupporting

confidence: 59%

“…However, it may also be caused by various pathological conditions including mesenteric edema, lymphedema, inflammation, hemorrhage, trauma and neoplasm [1][2][3][4][5][6]8,18 . Additionally Unlu et al 19 revealed that prevalence of idiopathic incidental misty mesentery appearance was 7% in obese patients based on the high body mass indices of these patients, chronic low grade inflammatory changes induced by adipose tissue deposition which are suggestive of an association between obesity and appearance of MM on CT.…”

Section: Discussionmentioning

confidence: 99%

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Misty mesentery in patients with ureterolithiasis: just coincidence?

Tekin¹,

Ulus²,

Türk³

et al. 2019

MMJ

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Objective: The purpose of this study is to evaluate the misty mesentery sign on computed tomography in patients with ureterolithiasis. Methods: This retrospective study enrolled all consecutive patients with ureteral stone diagnosed in abdominal computed tomography in the 3-year study period. Computed tomography scans were reviewed to assess the presence and interrelations between misty mesentery, ureteral diameter, volume and location of stones, presence of periureteral and perinephric stranding, thickening of the perirenal fascia, nephromegaly, and grade of hydronephrosis. Results: Four hundred thirty-four patients were included in the analysis. Misty mesentery was identified in 62 (14.2%) patients. Patients with misty mesentery were significantly older (mean age=45.2±12.2) than those without (mean age=37.3±10.9) (p=0.022). Perirenal fascial thickening was identified in 101 (23.2%) patients and found to be significantly associated with misty mesentery (c 2 =7.74, p=0.005). Two hundred patients (46%) were noted to exhibit periureteral stranding which was noted to be significantly related with misty mesentery (c 2 =13.6, p=0.000). The relationship between misty mesentery and pelvicalyceal ectasia, perinephric stranding, ureteral location of the stone, and nephromegaly were not found statistically significant. Conclusions: Ureterolithiasis can be accompanied by misty mesentery at computed tomography examination. There may be a potential association between ureterolithiasis and misty mesentery.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Misty mesentery in patients with ureterolithiasis: just coincidence?

Tekin¹,

Ulus²,

Türk³

et al. 2019

MMJ

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“…They hypothesized that changes in the mesenteric adipose tissue in inflammatory states (MP) might be similar to T2D because inflammation has been recognized to play a role in pathophysiology of T2D. Unlu et al noted that people with idiopathic misty mesentery had high BMIs: 67.5% were classified as obese and 17.5% as overweight [ 44 ]. Misty mesentery is also considered to be an important CT sign indicating early stage of MP.…”

Section: Discussionmentioning

confidence: 99%

“…Phlebitis seldom if ever happens in ordinary cases of MP, but may in those with suspected IgG4-RD [ 42 ]. An emerging concept of the possible relationship between MP and obesity and/or T2D suggests that MP may be an inflammation exclusively involving the mesenteric adipose tissue [ 43 , 44 ]. Hence, we believe that mesenteric panniculitis would be the best umbrella term to encompass a spectrum of rare idiopathic diseases characterized by chronic and fibrotic inflammatory changes in adipose tissue of the mesentery.…”

Section: Discussionmentioning

confidence: 99%

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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