Sclerosing Mesenteritis: Diverse clinical presentations and dissimilar treatment options. A case series and review of the literature

Abstract

Sclerosing mesenteritis (SM) is a rare pathological condition affecting the mesentery. It is a benign, non-specific inflammation of the adipose tissue of the mesentery of the small intestine and colon. It is characterized by a variable amount of chronic fibrosis. Its etiology is unknown, the pathogenesis is obscure, while the pathological characteristics of the disease are unspecific. The initial clinical presentation varies from typically asymptomatic to that of an acute abdomen. The diagnosis is suggested by computed tomography but is usually confirmed by surgical biopsies. Treatment is largely empirical; it is decided upon on the basis of the clinical condition of the patient, and usually a few specific drugs are used. Surgical resection is sometimes attempted for definitive therapy, although the surgical approach is often limited. We will present five cases of SM as well as a review of the available literature in order to state and compare a variety of clinical presentations, diverse possible etiologies and dissimilar treatment options.

Mesenteric Panniculitis (MP) in CT – A Predictor of Malignancy?

“…However, due to the retrospective analysis of all CT data sets, it is possible to provide complete representation of the prevalence in our cohort. MP can be reliably diagnosed on a purely morphological basis under consideration of the diagnostic criteria [10,11,21]. A keywordbased database search may include the error of incorrectly low diagnosis of MP since some authors consider MP underdiagnosed [17,20].…”

Sclerosing Mesenteritis-Update on Diagnostic and Therapeutic Approach

“…Affects primarily the mesentery of the small intestine, and the involvement of the colonic mesentery observed in about 20% of cases [2]. May involve, even, more rarely, the fat, retroperitoneal and pelvic peripancreática [3]. It was first described as mesenteritis retractable in 1924 and less than 300 cases were reported around the world [1].…”

“…Thus, the therapeutic decisions are guided by anecdotal experience/ empirical and case reports published in world literature [3]. A more recent study described a prevalence of 0.6% in more than 7000 abdominal computed tomography examinations [5].…”

“…The rarity of this condition restricts our study the demographic characteristics and clinical approach, as well as natural history and response to therapy disease [3][4][5]. Thus, the therapeutic decisions are guided by anecdotal experience/ empirical and case reports published in world literature [3].…”

“…Presents various terminologies, such as mesenteritis, mesenteric panniculitis, nodular systemic panniculitis retractable, liposclerosis mesenteritis, mesenteric xanthogranulomatous, inflammatory pseudotumor and lipogranulomatosis [2,3].…”