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• W2914772887 abstract "Mesenteric panniculitis is a benign fibrosing inflammatory condition of adipose tissue of mesentery. Our aim is to present a case of a patient with abdominal pain who had mesenteric panniculitis on abdominal imaging and was found to have mesenteric follicular lymphoma. A 64 year old male with history of hyperlipidemia presented with severe abdominal pain for 7 days which was located in upper abdomen and associated with vomiting. Examination showed stable vitals and upper abdominal tenderness. The routine laboratory results were normal. Ultrasound abdomen showed gallstones without any biliary obstruction or signs of cholecystitis. CT scan of abdomen revealed severe central mesenteric panniculitis with small peri-aortic nodes. Gallbladder ejection fraction was 20% on HIDA scan. Patient underwent laparoscopic cholecystectomy and mesenteric lymph node biopsy which showed atypical lymphoid infiltrate in adipose tissue suspicious of follicular lymphoma. Inflammation of mesenteric fat tissue characterized by chronic inflammation, fibrosis and necrosis is called mesenteric panniculitis (MP). It is also known as mesenteric lipodystrophy, sclerosing mesenteritis or mesenteric adenitis. Exact etiology is unknown. MP is associated with variety of neoplasms, previous abdominal surgeries or trauma, autoimmune conditions, infections and gastrointestinal conditions (pancreatitis, cirrhosis, peptic ulcer, cholelithiasis and celiac disease). It most commonly involves mesentery of small intestine (found in 90% cases) but it can also involve colonic mesentery. It is asymptomatic in 30-50% cases, it can present as chronic abdominal pain, bloating, diarrhea and infrequently as vomiting, weight loss and constipation. CT scan is imaging modality of choice and shows findings of fat ring sign and tumor pseudo capsule. Biopsy is required for definite diagnosis. MP is usually benign. Symptomatic patients have responded well to steroids. Glucocorticoids in combination with tamoxifen are the preferred first-line therapy while azathioprine or cyclophosphamide may be useful adjuncts. Surgery is recommended for cases where medical therapy is unsuccessful or for patients who develop complications as bowel obstruction or perforation. Mesenteric panniculitis is complex disorder with variable presentation. It may be associated with serious underlying conditions such as neoplasms. Early diagnosis treatment should be individualized based upon symptoms, complications and comorbidities." @default.
• W2914772887 created "2019-02-21" @default.
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• W2914772887 date "2017-10-01" @default.
• W2914772887 modified "2023-09-26" @default.
• W2914772887 title "Mesenteric Panniculitis: An Unusual Case of Abdominal Pain Due to Undiagnosed Lymphoma" @default.
• W2914772887 doi "https://doi.org/10.14309/00000434-201710001-02406" @default.
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