Mesenteric panniculitis, a rare entity presenting as (sub)acute intestinal obstruction: a case report

Abstract

Mesenteric panniculitis (MP) is a rare condition. A few literatures have been published reporting MP. No prior case reports have been published from Nepal. We report 1 such case of MP mimicking an intestinal obstruction at our Center. A 79-year-old lady presented with complaints of diffuse abdominal pain associated with vomiting. X-ray abdomen showed multiple thickened and dilated small bowel loops. Ultrasound of the abdomen revealed prominent small bowel loops with sluggish peristalsis. A provisional diagnosis of intestinal obstruction was made. A contrast-enhanced computerized scan of the abdomen-pelvis showed diffuse, heterogeneous mesenteric fat stranding. She was started on oral prednisolone (40 mg once daily) and discharged on the fourth day. Her follow-up 2 weeks later was uneventful. The steroid was tapered gradually over the next week. With a wide spectrum of clinical manifestations, MP often poses diagnostic challenges to physicians. Lack of awareness of the disease may be associated with an increased disease burden to patients. MP should also be considered as a differential diagnosis when features of bowel obstruction are present.