Four Cases of Postoperative Sclerosing Mesenteritis

Mesenteric panniculitis is an extremely rare inflammatory condition of the adipose tissue of unknown etiology. It is characterized by extensive, progressive fibrosis of the mesenteric fat tissue, leading to tumor formation. Clinical manifestations vary according to the process involving the structures. Abdominal pain accompanied by nausea, malaise, pyrexia, and weight loss and a poorly defined mass are common presentations. Major pathologic changes include (1) degeneration of mesenteric fat, (2) an inflammatory reaction, and (3) fibrosis of the adipose tissue. We present four patients with an aggressive form of mesenteric pannicultis with characteristic histopathologic features. We discuss the relationship between the histopathologic features and the surgical intervention in these cases.

Sclerosing Mesenteritis

Sclerosing mesenteritis is a rare condition; it's an idiopathic nonspecific inflammatory process in the adipose tissue of the small bowel mesentery. It often develops into huge masses that contain necrotic fat, and these masses mimick malignancy. It has two pathologically different variants: mesenteric panniculitis (acute or subacute) and retractile-mesenteritis (chronic). Although infection, trauma, local ischemia, surgery and malignancy have been implicated in the etiology of this disease, the exact causes are unknown. The disease usually has a favorable prognosis. The diagnosis is confirmed by biopsy. A 59 year-old man visited in our hospital with vague abdominal pain and diarrhea that he had suffered with during the previous three months. A computed tomography (CT) scan showed a dilated small intestine and also masses in the small bowel mesentery. On the operative findings, fibrous masses were noted in the mesentery. The pathologic report revealed sclerosing mesenteritis. We report here on a case of sclerosing mesenteritis along with a review of the literatures.

Cases of Postoperative Mesenteric Panniculitis

Mesenteric panniculitis is a rare inflammatory condition of mesenteric adipose tissue in which the mesentery is replaced with fibrosis. The frequent symptoms of mesenteric panniculitis are palpable mass, abdominal pain and gastrointestinal obstructive symptoms. In the majority of cases, its course is self-limiting and the prognosis is favorable. 3 cases of mesenteric panniculitis are described that presented with obstructive symptoms of gastrointestinal tract, which occurred in 2 weeks following colectomy of colonic tumors. And reviewed the symptomatology, pathology, treatment, and outcome of this disorder.