Nodular intra‐abdominal panniculitis: an accompaniment of colorectal carcinoma and diverticular disease

Abstract

Intra-abdominal panniculitis is a tumour-like inflammatory condition of adipose tissue. The aetiology and pathogenesis of the disease is unknown, but a number of associated diseases have been recorded. It has been customary to deal with only primary cases in the literature. This study was undertaken in order to describe the entire spectrum of the disease including primary as well as secondary cases. Eleven patients are reported, nine of which had an associated colorectal disease in direct continuity with areas of intra-abdominal panniculitis. It is concluded that intra-abdominal panniculitis should not be regarded as a specific nosological entity but merely a result of injury to the fat cells. Intra-abdominal panniculitis is seen more often as a secondary local phenomenon than as a primary condition, and in both cases it is associated with considerable differential diagnostic problems. Primary diseases involved are, among others, colorectal carcinoma and diverticulosis. The aetiologic agent(s) are still unknown, but substances liberated from a damaged bowel might play a pathogenetic role.

Nodular Sclerosing Mesenteritis: An Occasional Finding Mimicking a Spindle Cell Tumor

“…Sclerosing mesenteritis is a disease whose symptoms are unclear and difficult to identify. In the literature, the most frequently reported symptoms were abdominal pain, diarrhea, and weight loss [ 1 ], obstructive symptoms [ 2 , 7 ], abdominal mass [ 4 , 5 , 9 ], and unusual presentations due to the disease localization; in some cases, no relevant symptoms were reported [ 2 , 3 , 8 ]. Because of the low prevalence [ 10 ] and the heterogeneous presentations, sclerosing mesenteritis is seldom considered in the differential diagnosis.…”

“…Because of the low prevalence [ 10 ] and the heterogeneous presentations, sclerosing mesenteritis is seldom considered in the differential diagnosis. Frequently, the patient undergo surgery for the complications [ 4 , 6 ] and bowel and/or mass resection is performed [ 5 , 6 , 11 , 12 ]. Because the symptomatology is so uncertain and diverse, imaging may help in the diagnosis [ 13 ].…”

“…A multidisciplinary approach is therefore recommended. Steroid therapy may help reduce symptomatology [ 2 , 15 ] and is used in postoperative care [ 5 ].…”

“…Sclerosing mesenteritis, first described by Jura et al as “retractile mesenteritis” in 1924 [ 3 ], was later (1965) renamed by Ogden et al as “mesenteric panniculitis” [ 4 ]. Sclerosing mesenteritis has been reported in association with colorectal carcinoma, diverticular disease, and strangulated inguinal hernias as localized and nodular forms of panniculitis, sometimes with retraction and distortion of the intestinal loops, with adhesions between them [ 5 ].…”