Mesenteric Panniculitis in the Elderly - Update on Diagnostic and Therapeutic Approach

Abstract

The Mesenteric Panniculitis (MP) is a rare, non-specific inflammatory condition, mainly affecting the benign intestinal mesentery. It knew that she is diagnosed primarily during the sixth and seventh decade of life and seems to be two times more common in men than in women. The etiology of SM remains unknown, although several mechanisms have been suggested contributors, including surgery or abdominal trauma before, autoimmunity, paraneoplastic syndrome, ischemic injury, and infections. The major signs and symptoms are abdominal pain, the presence of palpable abdominal mass, nausea and vomiting, bowel changes, weight loss, small bowel obstruction, chylous ascites and peritoneal irritation signals. About of 10% of the patients are asymptomatic. The radiological study, especially computed tomography (CT) and magnetic resonance imaging (MRI), are essential components of the diagnostic evaluation. The "greasy" ring signal and the pseudocapsule tomographic findings are considered specific tumoral this pathology. The histopathologic study establishes the diagnosis. There is no specific treatment for SM and should this be empirical and individualized. Although they are described cases of spontaneous remission, some authors have shown benefit with the empirical treatment using corticosteroids, colchicine, immunosuppressants, antibiotics, tamoxifen, alone or in combination. The surgical approach has a limited role and usually aimed at symptomatic relief. In most cases, the prognosis is favorable.

Pediatric mesenteric panniculitis: three cases and a review of the literature

“…Similar to adults, the most common finding in children is abdominal pain, sometimes presenting as acute abdomen, leading to surgical intervention. 2,[21][22][23] Two of the cases in this paper presented with signs and symptoms of acute abdomen, one of them had a preliminary diagnoses of appendicitis resulting in surgical intervention the other patient received an explorative laparotomy.…”

“…1 It is commonly seen in the mesenteric fat tissue of small bowel and less frequently in the mesenteric fat tissue of large bowel. 2 Several pathophysiological mechanisms such as past surgical history, trauma, hypoxia, allergy, infections and autoimmunity have been considered in the etiopathogenesis of mesenteric panniculitis. 3 One of the mechanisms is monoclonal / oligoclonal B cell proliferation.…”

“…8 There is no consensus on the management and treatment of the disease, particularly in children. 2,9 Case 1 A five-month-old girl was admitted to the hospital with irritability and vomiting that started in the morning. On physical examination; she had dehydration and abdominal distention, without bowel movement on auscultation.…”

Mesenteric panniculitis

“…Mesenteric panniculitis is a rare and benign acute and chronic inflammatory and fibrotic process that affects predominantly the small and less frequently (20%) the large intestine mesenteric fat. 1 2 It may more rarely involve retroperitoneal, pelvic and peripancreatic fat. It is more common in men, with a male-to-female ratio of 2–3:1, and it is more common in Caucasian men.…”

Diagnostic Findings of Sclerosing Mesenteritis and the Disease Correlations with Caecal Adenocarcinoma

“…[1][2][3][4] The etiology remains unknown and hypothesized to be associated with previous abdominal surgery, abdominal trauma, autoimmune disease, drugs, cancer, ischemia, and infection. [5][6][7] The prevalence is 0.16-7.8%.…”