A Case of Mesenteric Panniculitis with the onset of Acute Peritonitis, Successful Treatment with Immunoglobulin

Naoto Kato, Hiroharu Suzuki^*, Junichi Tanaka^*, Yasushi Rino, Toshio Imada, Tomishige Amano and Yoshinori Takanashi

First Department of Surgery, Yokohama City University School of Medicine
Department of Surgery, Hadano Red-cross Hospital^*

The case study is an 48-year-old male who had come to our hospital complaining mainly of abdominal pain and fever. CT scans of the abdomen showed an increase in the density of the mesenterium. Although the patient was suspected of having mesenteric panniculitis, the diagnosis was pan-peritonitis because of strong rebound tenderness and muscular defense. Laparotomy findings included thickening and redness of the mesenterium of the small intestine. During surgery, the condition was confirmed to be mesenteric panniculitis. Biopsy of the mesenterium and abdominal drainage were performed. Mesenteric panniculitis was also diagnosed histopathologically. Anti-biotics were administered from the first operative day, but his temperature remained consistently above 39°C for eight days. Immunoglobulin was tried from the eighth post operative day, reducing the high fever as well as the white blood cell count and the blood level of C-reactive protein (CRP). Mesenteric panniculitis is a rather rare disease of unknown cause, characterized by nonspecific inflammation of mesenteric adipose tissue. We report successful treatment of a patient with immunoglobulin.

Key words
mesenteric panniculitis, γ-globulin

Reprint requests
Naoto Kato First Department of Surgery, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama-city, 236-0004 JAPAN

Accepted
April 26, 2000

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