An analysis of clinical characteristics of twelve cases of mesenteric panniculitis
10.3760/cma.j.issn.0578-1426.2017.02.006
- VernacularTitle:肠系膜脂膜炎12例临床特征分析
- Author:
Qingwei JIANG
;
Fengdan WANG
;
Wenze WANG
;
Xi WU
;
Huijun SHU
;
Jingnan LI
;
Aiming YANG
;
Jiaming QIAN
;
Dong WU
- Keywords:
Panniculitis,peritoneal;
Abdominal pain;
Tomography,X-ray computed;
Glucocorticoids;
Immunosuppressive agents
- From:
Chinese Journal of Internal Medicine
2017;56(2):112-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective Mesenteric panniculitis is an idiopathic , uncommon disease involving the adipose tissue of mesentery .The etiology , diagnosis and treatment are still unnoticed .We thus reported a case series to improve the understanding of this rare disorder .Methods We retrospectively analyzed the clinical data of 12 patients with mesenteric panniculitis including manifestation , diagnosis, treatment and prognosis.Results We found a male predominance (M∶F 3∶1) with the median age of 58 years old at diagnosis.The most common symptom was abdominal pain (9/12), followed by abdominal distension (3/12) and weight loss (3/12).Physical examination was unremarkable in the majority of patients (8/12).C reactive protein (9/12) and erythrocyte sedimentation rate (10/12) were normal in majority of patients.CT findings were of much diagnostic value .All patients had small intestinal mesentery involvement and multi-nodular appearance with increased fat density .Pseudo-capsule sign ( 8/12 ) and fat halo sign (6/12) were common.Pathological diagnosis was obtained in 4 cases showing fat tissue inflammation with local necrosis and fibrosis .Six cases all received prednisone , 2 with combined cyclophosphamide , 1 with azathioprine, 1 with tripterygium wilfordii .Short-term clinical response was achieved in all cases , but two patients relapsed .Conclusions Mesenteric panniculitis occurs predominantly in middle-aged and elderly . Abdominal pain is the leading symptom .Inflammatory markers are often normal while computed tomography is the most important diagnostic tool .Surgery combined with cortical steroid and immunosuppressant agents is effective.
