CT Features of Mesenteric Panniculitis

Mata, Josep M.; Inaraja, L; Martin, J. Chad; Olazabal, Ainhoa Alonso; Castilla, M T

doi:10.1097/00004728-198711000-00018

Cited by 67 publications

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“…Cystic components have also been described and may be the result of lymphatic or venous obstruction as well as necrotic change. Two CT findings are considered more specific for the diagnosis of MP as they have not been reported in other mesenteric diseases (3,5,(23)(24)(25)(26): the presence of a tumoral pseudocapsule (found in up to 60% of MP cases) and the "fat ring" sign of hypodense fatty halo surrounding mesenteric nodules and vessels (seen in up to 75% of cases) (5,8,12,(27)(28) (figures 1, 3, On occasions, the disease may also present with merely a single or multiple palpable masses. Exceptionally, rectal bleeding, jaundice, gastric outlet obstruction, and even acute abdomen have been reported.…”

Section: Diagnosismentioning

confidence: 99%

Mesenteric panniculitis part 1: mdct - pictorial review

Coulier

2011

Journal of the Belgian Society of Radiology

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Mesenteric panniculitis is an uncommon benign inflammatory condition of unknown etiology that involves the adipose tissue of the mesentery and for which an extremely varied terminology has been used, causing considerable confusion. It can be evaluated as a single disease with two pathological subgroups: Mesenteric Panniculitis (MP), representing the very large major subgroup where inflammation and fat necrosis predominate and Retractile Mesenteritis (RM), much rarely found, where fibrosis and retraction predominate. In histo-pathological terms the preferred terminology is sclerosing mesenteritis. We hereby extensively illustrate the characteristic MDCT findings of MP through pictures selected among a collection of cases constituted over a 5-year period. All patients were scanned with 64-row MDCT equipment. We also review the literature and discuss the differential diagnosis. The radiological diagnosis of MP was based on classical CT signs described in the literature and comprising: the presence of a well-defined "mass effect" on neighbouring structures (sign 1) constituted by mesenteric fat tissue of inhomogeneous higher attenuation than adjacent retroperitoneal or mesocolonic fat (sign 2) and containing small soft tissue nodes (sign 3). It may typically be surrounded by a hypoattenuated fatty "halo sign" (sign 4) and an hyperattenuating pseudocapsule may also surround the all entity (sign 5). The last two signs are considered inconstant but very specific. The absence of histological verification constitutes the weakness of our study. The differential diagnosis of MP is extensive and includes all disorders that can affect the mesentery. The most common ones are lymphoma, well-differentiated liposarcoma, peritoneal carcinomatosis, carcinoid tumor, retroperitoneal fibrosis, lipoma, mesenteric desmoid tumor, mesenteric inflammatory pseudotumor, mesenteric fibromatosis and mesenteric edema. PET/CT is proved useful to correctly exclude mesenteric tumoral involvement in patients presenting with typical MP. The course of MP is favorable in most cases and progression of MP to retractile mesenteritis not only appears very being rare but finally remains doubtful.

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Section: Diagnosismentioning

confidence: 99%

Mesenteric panniculitis part 1: mdct - pictorial review

Coulier

2011

Journal of the Belgian Society of Radiology

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“…other mesenteric diseases (1,4,6,(12)(13)(14)(15): the presence of a tumoral pseudocapsule (found in up to 60% of MP reported cases) and the "fat ring" sign of hypodense fatty halo surrounding mesenteric nodules and vessels (seen in up to 75% of reported cases) (1, 6, 8, 16-18) (Fig. 1).…”

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Mesenteric panniculitis part 2: prevalence and natural course: mdct prospective study

Coulier

2011

Journal of the Belgian Society of Radiology

120

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“…Panniculitis of the Mesentery komponent olması halinde hastalığın "retraktil mezenterit" olarak adlandırıldığı bildirilmiştir (10)(11)(12)(13). Mezenterik pannikülitin etyolojisi net olmamakla beraber ilişkilendirildiği pek çok hastalık vardır.…”

Section: Discussionunclassified

Panniculitis of the Mesentery

Başol¹,

Taş²,

Ayan³

et al. 2013

JAEMCR

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The mesentery is the double layer of peritoneum that suspends the small intestine (jejunum and ileum) from the posterior wall of the abdomen. The superior mesenteric artery and its branches, accompanying veins, lymphatic, lymph nodes, the autonomic nerve plexuses, with a larger amount of connective tissue and varying amounts of fat tissue around the root of the mesentery, are located between two layers of peritoneum. Mesenteric panniculitis is a benign disorder that characterised by fat necrosis, chronic inflammation, and fibrosis. Although the aetiology is not clear, it is associated with many diseases, such as previous abdominal surgery, and malignancies. Mesenteric panniculitis may be asymptomatic or accompanied by symptoms such as abdominal pain, abdominal distention, palpable mass, and fever. Laboratory tests are non-specific in diagnosis. Although diagnosis of the disease is usually with ultrasound and abdominal CT is definitive, diagnosis is made by histopathological examination. Usually, symptomatic treatments are administered in mesenteric panniculitis; however, immunosuppressive agents or steroids have also been reported to be effective. In this study, we report three cases admitted to the emergency room with abdominal pain and diagnosed as mesenteric panniculitis, to draw attention to the cause of this rare abdominal pain.Keywords: Mesentery, panniculitis, abdominal pain Received: 07.04.2012 Accepted: 28.04.2012 ÖZET Peritonun çift katlı tabakası olan mezenterium ince bağırsakları (jejunum ve ileum) karın arka duvarına asar. Mezenterin her iki yüzünde peritonun çift katmanı arasında a.mesenterica superior ve dalları, bunlara eşlik eden venler, lenfatikler, lenf düğümleri, otonom sinir pleksusları, bağ dokusu ve kök civarında daha büyük miktarda bulunan değişik miktarlarda yağ dokusu vardır. Mezenterik pannikülit; yağ nekrozu, kronik inflamasyon ve fibrozis ile karakterize iyi huylu bir hastalıktır. Etiyolojisi net olmamakla birlikte geçirilmiş abdominal cerrahi, malignensiler gibi ilişkilendirildiği pek çok hastalık mevcuttur. Mezenterik pannikülit, semptomsuz seyredebileceği gibi karın ağrısı, abdominal distansiyon, ele gelen kitle, ateş gibi semptomlarla da seyredebilir. Tanısında Laboratuvar tetkikleri non spesifiktir. Tanısı genelde USG ve batın BT ile konulsa da kesin tanıya histopatolojik incelemeler neticesinde ulaşılır. Mezenterik pannikülit de genellikle semptomatik tedaviler uygulanmakla birlikte immünsüpresif ajanlar yada steroidlerin etkili olduğu da bildirilmiştir. Bu çalışmada biz acil servise karın ağrısı şikayeti ile başvuran ve mezenterik pannikülit tanısı konulan üç olguyu sunduk, böylelikle karın ağrısının bu nadir sebebine dikkat çekmek istedik. GirişKarın ağrısı acil servise başvuruların yaklaşık %5-10'luk önemli bir kısmını oluşturan bir durumdur (1). Hastaların %20-25'inde başvuru sonrası hastaneye yatış gerekirken, %35-40'ında ise yapılan tetkiklere rağmen hiçbir patolojinin saptanmadığı, ağrının genellikle kendiliğinden sonlandığı ve nonspesifik karın ağrısı olarak de...

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CT Features of Mesenteric Panniculitis

Cited by 67 publications

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Mesenteric panniculitis part 1: mdct - pictorial review

Mesenteric panniculitis part 1: mdct - pictorial review

Mesenteric panniculitis part 2: prevalence and natural course: mdct prospective study

Panniculitis of the Mesentery

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