ABSTRACT
Sclerosing mesenteritis or panniculitis is a rare condition characterized by inflammation of the mesentery ranging from an acute to a chronic fibrotic process that can resemble an intestinal malignant neoplasm even though it is benign. Its etiology is unknown, although it is thought to be the result of a nonspecific inflammatory response of the mesentery to an allergic, chemical, thermal, infectious, autoimmune or surgical stimulus. Its natural history is benign and in most cases is self-limited. Surgery is reserved only for those cases where there is intestinal obstruction. We report three cases of sclerosing mesenteritis that occurred after abdominal surgery and we present a review of the literature.
Subject(s)
Panniculitis, Peritoneal/diagnosis , Postoperative Complications/diagnosis , Adult , Anti-Inflammatory Agents/therapeutic use , Cholecystectomy , Cholecystitis/etiology , Cholecystitis/surgery , Colchicine/therapeutic use , Colectomy , Combined Modality Therapy , Diverticulosis, Colonic/surgery , Duodenal Diseases/etiology , Duodenal Diseases/surgery , Gastric Bypass/adverse effects , Gastritis/etiology , Humans , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Laparotomy , Male , Methylprednisolone/therapeutic use , Middle Aged , Panniculitis, Peritoneal/drug therapy , Panniculitis, Peritoneal/etiology , Panniculitis, Peritoneal/surgery , Postoperative Complications/drug therapy , Postoperative Complications/etiology , Prognosis , Reoperation , Tissue Adhesions/complications , Tissue Adhesions/surgeryABSTRACT
Sclerosing mesenteritis or panniculitis is a rare condition characterized by inflammation of the mesentery ranging from an acute to a chronic fibrotic process that can resemble an intestinal malignant neoplasm even though it is benign. Its etiology is unknown, although it is thought to be the result of a nonspecific inflammatory response of the mesentery to an allergic, chemical, thermal, infectious, autoimmune or surgical stimulus. Its natural history is benign and in most cases is self-limited. Surgery is reserved only for those cases where there is intestinal obstruction. We report three cases of sclerosing mesenteritis that occurred after abdominal surgery and we present a review of the literature.
Subject(s)
Humans , Male , Adult , Middle Aged , Postoperative Complications/diagnosis , Panniculitis, Peritoneal/diagnosis , Anti-Inflammatory Agents , Cholecystectomy , Cholecystitis , Colectomy , Combined Modality Therapy , Colchicine/therapeutic use , Duodenal Diseases , Gastric Bypass/adverse effects , Diverticulosis, Colonic/surgery , Gastritis/etiology , Intestinal Obstruction , Methylprednisolone/therapeutic use , Panniculitis, Peritoneal , Postoperative Complications , Prognosis , Reoperation , Tissue AdhesionsABSTRACT
Traumatic rupture of the thoracic aorta is a near-lethal event presenting on-scene mortality rates of 80% and 60-80% perioperatively with an overall survival rate of 15%. Conventional treatment includes thoracotomy with aortic clamping and aortic replacement but this implies high complication and mortality rates with extended inpatient care. Endoluminal treatment has recently become an attractive treatment option with advantages such as lower death and complication rates as well as shorter inpatient care. We present an 18-year-old female victim of a frontal automobile crash who presented mediastinal enlargement and underwent CT evaluation confirming pericardial effusion, left hemothorax and a contained traumatic rupture of the thoracic aorta. She was sent to our hospital where aortography was performed identifying the injury, and a preperitoneal left iliac artery approach was made to insert a Medtronic Talent 24F endograft. Under fluoroscopic guidance the graft was placed below the subclavian ostium. There was no endoleak after the procedure. A left iliac-femoral bypass was performed and a chest tube was inserted. The patient was managed in the ICU, being later operated by reconstructive and orthopedic surgeons for injuries related to the initial trauma. The patient was released from the hospital on the 10th postoperative day after a satisfactory evolution. We present also a brief review of recent articles.