A Case of Mesenteric Panniculitis

Kentaro Yamaguchi, Takao Katsube, Akira Tsuchiya, Syungo Endo, Takeshi Shimakawa, Hiroyuki Kato, Yoshihiko Naritaka, Syunsuke Haga, Kenji Ogawa, Testuro Kajiwara

Department of Surgery, Tokyo Women's Medical College Daini Hospital

The case study is an 83-year-old male who had come to hospital complaining mainly of abdominal pain and fever. CT scans of the abdomen showed an increase in the density of the mesenterium, and a high density funicular image in the inner part. Although the patient was suspected of having mesenteric panniculitis, diagnosis was pan-peritonitis because of the strong rebound tenderness and muscular defence. Laparotomy was performed. Almost the whole area of the mesenterium of the small intestine showed thickening, and blood circulation was impaired in the small intestine. During surgery, the condition was confirmed as mesenteric panniculitis. Atonic incisions in the mesenterium of the small intestine, biopsy, and abdominal drainage were performed. Mesenteric panniculitis was also diagnosed in the histopathological examination. Steroids were administed from the first post operative day, improved the abdominal symptoms and decreased the blood level of C-reactive protein (CRP). In this case, we observed CT scans of the abdomen taken at different stages in time, this case showed both a normalization in the density and volume which accompanies recovery from the symptoms. These findings characteristic of mesenteric panniculitis are also reported in the present study.

Key words
mesenteric panniculitis, CT, steroid

Reprint requests
Kentaro Yamaguchi Department of Surgery, Tokyo Women's Medical College Daini Hospital
2-1-10 Nishiogu, Arakawaku, Tokyo, 160-0011 JAPAN

Accepted
March 11, 1998

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