Occasional finding of mesenteric lipodystrophy during laparoscopy: A difficult diagnosis

Abstract

Mesenteric lipodystrophy is a rare pathological condition affecting the mesentery. Its initial presentation is typically asymptomatic. Pathological characteristics are unspecific, and generally attributed to inflammation, unless the diagnosis is suspected. Laparoscopy done for other reasons has been, as in this case, unsuccessful in providing evidence for the correct diagnosis, thus requiring laparotomy due to lack of diagnostic tissue. After 6 mo no further medical therapy is required, as the patient remains asymptomatic. Discussion of this case and a brief review of the literature are presented in the following paragraphs.

Mesenteric panniculitis part 1: mdct - pictorial review

“…In histo-pathological terms, the preferred terminology is sclerosing mesenteritis (2,10,12,17). It represents the more accurate terme because of the presence of some degree of fibrosis as a common denominator (3,17).…”

“…It was first described by Jura (6) in 1924 as "Retractile Mesenteritis" and further labeled as "Mesenteric Panniculitis" by Odgen (7) later in the 1960s. Only few large series have been reported and the literature comprises mainly case reports and studies of small series (8)(9)(10). Currently, the pathology has several names: sclerosing mesenteritis, mesenteric lipodystrophy, mesenteric panniculitis, mesenteric sclerosis, retractile mesenteritis, mesenteric Weber-Christian disease, liposclerotic mesenteritis, lipomatosis and lipogranuloma of the mesentery (1,3,4,(11)(12)(13)(14).…”

Mesenteric panniculitis: Various presentations and treatment regimens

“…If inflammation and fat necrosis predominate over fibrosis, the condition is known as mesenteric panniculitis, and when fibrosis and retraction predominate, the result is retractile mesenteritis. The overall presence of some degree of fibrosis makes the pathological term sclerosing mesenteritis more accurate in most cases [3] .…”

Panniculitis: rheumatological aspects

“…В соответствии с преобладанием патоморфологических воспалитель-ных изменений в брыжейке выделяют [22]. МПн часто протекает бессим-птомно и является диагностической находкой во время компьютерной или магнитно-резонансной томографии при обследовании брюшной полости [23].…”