Surgical Treatment for Mesenteric Panniculitis -Report of Two Cases-

Tatsuo Ikeno¹⁾²⁾, Atsushi Sugiyama¹⁾³⁾, Kunihiko Shimura¹⁾, Hideyuki Ichikawa²⁾, Kenji Kawaguchi⁴⁾ and Seiji Kawasaki⁵⁾

¹⁾Department of Surgery, Shinshu University School of Medicine, ²⁾Department of Surgery, Naganoken-Koseiren, Shinonoi General Hospital, ³⁾Medical Care Networking Center, Shinshu University Hospital, ⁴⁾Department of Pathology,
Naganoken-Koseiren, Shinonoi General Hospital, ⁵⁾Second Department of Surgery, Juntendo University School of Medicine

Mesenteric panniculitis is a rare inflammatory process of the mesenteric fat tissue with unknown etiology. We report 2 cases of mesenteric panniculitis of the large intestine successfully treated by surgery and review the relevant literature. A 65-year-old man admitted for ileus symptoms was found in double contrast radiography of the large intestine to have segment narrowing in the descending colon. Computed tomography showed of the descending colon wall thickened and surrounded by fatty tissue. Treatment with TPN and antibiotics provided no relief, so we conducted left colectomy. Histologically, degeneration and necrosis of fat cells were seen and mesenteric panniculitis confirmed. Postoperatively, ileus symptoms disappeared and he is doing well. A 61-year-old man admitted to a local clinic for low abdominal pain and diarrhea, was treated conservatively under a diagnosis of ulcerative colitis, but symptoms did not disappear and he was referred to our hospital. Colonoscopy showed reddish, swollen, tumor-free edema from the rectum to the sigmoid colon. Computed tomography showed findings similar to the first case, necessitating sigmoid colectomy. Postoperatively, the man is doing well.

Key words
mesenteric panniculitis, ischemic colitis

Reprint requests
Tatsuo Ikeno Department of Surgery, Naganoken-Koseiren, Shinonoi General Hospital 666-1 Ai, Shinonoi, Nagano, 388-8004, JAPAN

Accepted
January 22, 2003

To read the PDF file you will need Abobe Reader installed on your computer.