Paniculitis mesentérica: experiencia en nuestro centro

Abstract

La paniculitis mesentérica es un proceso inflamatorio crónico inespecífico del tejido adiposo mesentérico (1) con una forma de presentación muy variable. Para su diagnóstico definitivo suele ser necesario recurrir a la toma de biopsia de la lesión debido a la falta de especificidad de las pruebas radiológicas y la incapacidad de reconocer mucho de los factores precipitantes. Actualmente se reconoce que esta entidad presenta varios estadios evolutivos. Los criterios diagnósticos anato

Mesenteric panniculitis: Various presentations and treatment regimens

“…Blood tests tend to be within the normal range. Neutrophilia, increased erythrocyte sedimentation rate or anemia have been reported occasionally in the retractile mesenteritis stage [6] . Some reports even go as far as stating that few or none of the patients with mesenteric panniculitis can be diagnosed correctly before operation [4,14] .…”

“…Most studies have indicated that the disease is more common in men, with a male/female ratio of 2-3:1, and several reports have indicated it to be more common in Caucasian men. Incidence increases with age, and pediatric cases are exceptional, probably because children have less mesenteric fat when compared to adults [6] .…”

“…Histologically, the disease progresses in three stages [6] . The first stage is mesenteric lipodystrophy, in which a layer of foamy macrophages replaces mesenteric fat.…”

“…More recent studies have shown a strong relationship between tobacco consumption and panniculitis [7] . Retractile mesenteritis has been associated with a number of malignant diseases such as lymphoma, lung cancer, melanoma, colon cancer, renal cell cancer, myeloma, gastric carcinoma, chronic lymphocytic leukemia, Hodgkin's disease, large cell lymphoma (giant-cell carcinoma), carcinoid tumor, and thoracic mesothelioma [2,6,7,[9][10][11] . In over 90% of cases, mesenteric panniculitis involves the small-bowel mesentery, although it may sometimes involve the sigmoid mesentery [10] .…”

“…Emory et al [2] have reported a series in which 84% of patients had a history of abdominal trauma or surgery. Furthermore, the disease is related to other factors, such as mesenteric thrombosis, mesenteric arteriopathy, drugs, thermal or chemical injuries, vasculitis, avitaminosis, autoimmune disease, retained suture material, pancreatitis, bile or urine leakage, hypersensitivity reactions, and even bacterial infection [6,7] . Other factors, such as gallstones, coronary disease, cirrhosis, abdominal aortic aneurysm, peptic ulcer, or chylous ascitis, have also been linked to this disease [8] .…”