Approach to cases diagnosed with mesenteric panniculitis

Abstract

Objective: In this study, it was aimed to report the diagnosis, treatment and follow-up results of patients who came to the hospital with complaints of abdominal pain and were diagnosed with Mesenteric Panniculitis (MP) by Abdominal Computed Tomography (ACT). Method: 32 patients diagnosed with MP by ACT were examined retrospectively. The patients' age, gender, admission leukocyte count, CRP values, comorbidities, medications prescribed at discharge, and relapse status were evaluated. Results: Of the 32 patients included in the study, 11 were male (34.4%), 21 were female (65.6%), and they had a mean age of 58.75±12.31 years. The average leukocyte value at first admission was 8240±2530 /mm³, CRP average 24.93±47.39 mg/L, neutrophil percentage was not above 80% in any patient. No patients were hospitalized. Recurrence was occurred in 2 (6.25%) patients (after 6 months and 28 months). No malignancy were during follow-up. Conclusion: MP was diagnosed with ACT. No biopsy was required for diagnosis. Medical treatment was sufficient, no surgical procedure was performed on the patients.

Keywords

• Abdominal Pain
• Computed Tomography
• Mesenteric Panniculitis

References

1. Bush RW, Hammar SP Jr, Rudolph RH. Sclerosing mesenteritis. Response to cyclophosphamide. Arch Intern Med. 1986;146(3):503-5. https://doi.org/10.1001/archinte.146.3.503
2. Nicholson JA, Smith D, Diab M, Scott MH. Mesenteric panniculitis in Merseyside: a case series and a review of the literature. Ann R Coll Surg Engl. 2010;92(6):W31-4. https://doi.org/10.1308/147870810X12699662981393
3. Daskalogiannaki M, Voloudaki A, Prassopoulos P, Magkanas E, Stefanaki K, Apostolaki E, Gourtsoyiannis N. CT evaluation of mesenteric panniculitis: prevalence and associated diseases. AJR Am J Roentgenol. 2000;174(2):427-31. https://doi.org/10.2214/ajr.174.2.1740427
4. Rosón N, Garriga V, Cuadrado M, Pruna X, Carbó S, Vizcaya S, Peralta A, Martinez M, Zarcero M, Medrano S. Sonographic findings of mesenteric panniculitis: correlation with CT and literature review. J Clin Ultrasound. 2006;34(4):169-76. https://doi.org/10.1002/jcu.20214
5. Başol, N. Mezenterik Pannikülit. Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi 2012;4(4), 1-7.
6. Amor F, Farsad M, Polato R, Pernter P, Widmann J, Mazzoleni G, Osele L, Wiedermann CJ. Mesenteric panniculitis presenting with acute non-occlusive colonic ischemia. Int Arch Med. 2011;22;4:22. https://doi.org/10.1186/1755-7682-4-22
7. Canyigit M, Koksal A, Akgoz A, Kara T, Sarisahin M, Akhan O. Multidetector-row computed tomography findings of sclerosing mesenteritis with associated diseases and its prevalence. Jpn J Radiol. 2011;29(7):495-502. https://doi.org/10.1007/s11604-011-0587-5
8. Hussein MR, Abdelwahed SR. Mesenteric panniculitis: an update. Expert Rev Gastroenterol Hepatol. 2015;9(1):67-78. ttps://doi.org/10.1586/17474124.2014.939632

9. Buragina, G., Magenta Biasina, A., & Carrafiello, G. Clinical and radiological features of mesenteric panniculitis: a critical overview. Acta bio-medica : Atenei Parmensis, 2019;90(4), 411–422. https://doi.org/10.23750/abm.v90i4.7696
10. Rees JR, Burgess P. Benign mesenteric lipodystrophy presenting as low abdominal pain: a case report. J Med Case Rep. 2010;27(4):119. https://doi.org/10.1186/1752-1947-4-119
11. Shah, D. M., Patel, S. B., Shah, S. R., & Goswami, K. G. Mesenteric panniculitis a case report and review of literature. Indian Journal of Radiology and Imaging, 2005:15(02), 191-192. https://doi.org/10.4103/0971-3026.28798
12. Azzam I, Croitoru S, Naschitz JE. Sclerosing mesenteritis: a diagnostic challenge. Isr Med Assoc J. 2004;6(9):567-8.
13. Alsuhaimi MA, Alshowaiey RA, Alsumaihi AS, Aldhaeeri SM. Mesenteric panniculitis various presentations and management: A single institute ten years, experience. Ann Med Surg (Lond). 2022;16;80:104203. https://doi.org/10.1016/j.amsu.2022.104203
14. Durst AL, Freund H, Rosenmann E, Birnbaum D. Mesenteric panniculitis: review of the leterature and presentation of cases. Surgery. 1977;81(2):203-11.
15. Hobson ML, Johari AS, Woon W, Haghighi KS. Mesenteric panniculitis causing ischemic bowel: a case report. Int Surg. 2008;93(4):238-40.
16. Koornstra JJ, van Olffen GH, van Noort G. Retractile mesenteritis: to treat or not to treat. Hepatogastroenterology. 1997;44(14):408-10.
17. Gögebakan Ö, Osterhoff MA, Albrecht T. Mesenteric Panniculitis (MP): A Frequent Coincidental CT Finding of Debatable Clinical Significance. Rofo. 2018;190(11):1044-1052. English. https://doi.org/10.1055/a-0633-3558
18. Diéguez Aliaga F, Larsson JC, Ballario F, García S, Granero L. Paniculitis mesentérica: presentación de un caso y revisión de la literatura [Mesenteric panniculitis: a case report and a review of the literature]. Acta Gastroenterol Latinoam. 2013;43(4):312-5.
19. Akram S, Pardi DS, Schaffner JA, Smyrk TC. Sclerosing mesenteritis: clinical features, treatment, and outcome in ninety-two patients. Clin Gastroenterol Hepatol. 2007;5(5):589-96; quiz 523-4. https://doi.org/10.1016/j.cgh.2007.02.032
20. Ferrari TC, Couto CM, Vilaça TS, Xavier MA, Faria LC. An unusual presentation of mesenteric panniculitis. Clinics (Sao Paulo). 2008;63(6):843-4. https://doi.org/10.1590/S1807-59322008000600023