Mesenteric panniculitis

Background

• Also known as sclerosing mesenteritis, mesenteric lipodystrophy, mesenteric sclerosis, retractile mesenteritis, mesenteric Weber-Christian disease, liposclerotic mesenteritis, lipomatosis and lipogranuloma of the mesentery
• A rare, benign, and chronic fibrosing inflammatory disease that affects the adipose tissue of the mesentery (of the small intestine and colon).
• Occurs independently (specific cause unknown) or in association with other disorders

Clinical Features

• Abdominal pain

Evaluation

• Regional increase in mesenteric fat density on abdominal CT (i.e. “misty mesentery”)
  • May be confirmed by surgical biopsy

Management

• Supportive ED treatment

There is no standardized treatment, and it may consist of anti-inflammatory or immunosuppressive agents. We recommend resection only when the advanced inflammatory changes become irreversible or in cases of bowel obstruction

• Chronic treatment includes workup of underlying etiology and consideration of medical therapy for severe/protracted disease (e.g. corticosteroids, cyclophosphamide, or azathioprine)

Disposition

• Outpatient

Prognosis

• Overall prognosis is usually good and recurrence seems to be rare