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A 67-year old male with a history of myocardial infarction status post percutaneous coronary intervention and stage IV bladder cancer status post radical cystoprostatectomy with ileal neobladder reconstruction and chemotherapy (cisplatin and gemcitabine) presented with progressive, severe epigastric and lower abdominal pain associated with nausea. The pain had intensified over the previous week and was associated with a recent fifteen pound weight loss in the setting of poor oral intake. He denied nausea or diarrhea.His physical exam was notable for abdominal tympany and tenderness. His labs were notable for mild hyperkalemia (potassium 5.0 mmol/L), normal white blood cell count, lipase of 28 U/L, normal liver function tests, and positive 2+ leukocyte esterase and 1+ blood in his urine. Upper endoscopy showed a small Schatzki's ring in the distal third of the esophagus with small hiatal hernia and gastritis. On CT, there was thickened, indurated mesentery and a mesenteric mass (Figure 1) with abdominal lymphadenopathy and a new adrenal nodule. EPIDEMIOLOGY & CLINICAL PRESENTATIONSclerosing mesenteritis, also known as mesenteric panniculitis, is part of a spectrum of idiopathic primary inflammatory and fibrotic processes that affect the mesentery and is characterized by inflammation of mesenteric fat. Although its etiology is unclear, it has been associated with previous abdominal surgery, autoimmunity, paraneoplastic syndromes, ischemic injury, and infection. Sclerosing mesenteritis is also associated with a high prevalence of coexisting malignancies and future cancer development. 1 In a study evaluating 7620 patients presenting with a chief complaint of abdominal pain, the prevalence was 0.6%. 2 The presentation of sclerosing mesenteritis is variable. In a series of 68 patients with sclerosing mesenteritis, 75% had abdominal pain, 26% had nausea/vomiting, 20% had anorexia and weight loss, and 20% had altered bowel habits. 3 In an 84-patient cohort, only 35% had abdominal pain, and 20% had an incidental abdominal mass on exam. 2 The duration of symptoms ranged from 24 hours to 2 years. 2 Up to 20% of patients with sclerosing mesenteritis develop complications, often intestinal obstruction from mass effect. 3 Other complications include mesenteric vascular occlusion, chylous ascites, and adverse effects from medications used to treat sclerosing mesenteritis.

Purpose Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during incarceration and equally so when transitioning back to the community. The purpose of this paper is to discuss the literature on challenges older adults (age 50 and over) face in maintaining health and accessing social services to support health after an incarceration and to outline recommendations to address the most urgent of these needs. Design/methodology/approach This study conducted a narrative literature review to identify the complex health conditions and health services needs of incarcerated older adults in the USA and outline three primary barriers they face in accessing health care and social services during reentry. Findings Challenges to healthy reentry of older adults include continuity of health care; housing availability; and access to health insurance, disability and other support. The authors recommend policy changes to improve uniformity of care, development of support networks and increased funding to ensure that older adults reentering communities have access to resources necessary to safeguard their health and safety. Originality/value This review presents a broad perspective of the current literature on barriers to healthy reentry for older adults in the USA and offers valuable system, program and policy recommendations to address those barriers.