Mesenteric panniculitis patients requiring emergency surgery: report of three cases.

Mesenteric panniculitis is a rare, benign disease characterized by a chronic non-specific inflammatory process of mesenteric fat tissue with unknown etiology. The small bowel mesentery is affected mostly. This process rarely involves the large intestine mesentery. Mesenteric panniculitis includes symptoms as abdominal pain, nausea and vomiting, diarrhea, constipation, and fever. In our cases, we had difficulty in the preoperative diagnosis as the clinical changes imitated an obstruction or ischemia of the small bowel. All the cases required emergency abdominal surgery and partial jejunal resection. The aim of this article was to present three cases of mesenteric panniculitis of the small bowel mesentery requiring emergency surgery together with a short review of the literature.

Small bowel tumors in emergency surgery.

BACKGROUND: The aim of the present study was to describe the clinical presentation, diagnostic work-up, surgical therapy, and prognosis of 13 patients with small bowel tumor admitted for surgical procedures in an emergency setting. METHODS: From 1996 to 2008, 13 consecutive surgical cases of small bowel tumors were treated at the Cumhuriyet University Faculty of Medicine, Department of General Surgery, and Kütahya State Hospital, Department of General Surgery. Clinical and radiological charts of these patients were reviewed retrospectively from the department database. RESULTS: Intestinal obstruction (7 cases) and perforation (5 cases) were the most common clinical presentations, followed by intussusception (1 case). Adenocarcinoma was the most frequent histologic type (4 cases), while small bowel sarcoma was seen in three cases and non-Hodgkin lymphoma in two cases. The remaining cases had carcinoid tumor, small bowel angioleiomyoma, Brunner's gland adenoma, and inflammatory pseudotumor of the small intestine. CONCLUSION: Small bowel tumors are rare, the symptoms often non-specific, and the accuracy of different diagnostic tests remains to be improved. Timing and type of the intervention to the process and biological behavior of the pathological cells predict the prognosis.