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Updated: May 31, 2026

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric panniculitis presenting with acute non-occlusive colonic ischemia
Florian Amor1, Mohsen Farsad, Romano Polato
1Division of Internal Medicine, Central Hospital of Bolzano, Lorenz Böhler Street 5, Bolzano 39100, Italy. christian.wiedermann@asbz.it.
Positron emission tomography-computed tomography (PET-CT) may not detect abnormal uptake in mesenteric panniculitis, a condition to consider for unexplained ischemic colitis. This imaging modality has a limited diagnostic role in such cases.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- The diagnostic utility of positron emission tomography (PET) in evaluating mesenteric panniculitis remains uncertain.
- Mesenteric panniculitis is a rare, chronic inflammatory condition affecting the mesentery.
Purpose of the Study:
- To investigate the role of PET-CT in diagnosing mesenteric panniculitis.
- To assess the diagnostic accuracy of PET-CT in a patient with unexplained ischemic colitis and suspected mesenteric panniculitis.
Main Methods:
- A case presentation of a 67-year-old woman with rectal bleeding due to nonocclusive colonic ischemia.
- Diagnostic imaging included abdominal CT and fluorine-18 fluorodeoxyglucose (F-18 FDG) PET-CT.
- Laparoscopic biopsies of mesenteric fat were performed to rule out malignancy.
Main Results:
- Abdominal CT revealed features consistent with mesenteric panniculitis.
- PET-CT showed no abnormal F-18 FDG uptake in the affected mesentery or adjacent lymph nodes.
- Biopsies excluded a neoplastic process, confirming panniculitis as the diagnosis.
Conclusions:
- Mesenteric panniculitis should be considered in the differential diagnosis of unexplained ischemic colitis.
- PET-CT may exhibit false-negative results in mesenteric panniculitis due to absent or low F-18 FDG avidity.
- The current role of PET-CT in the diagnostic work-up of mesenteric panniculitis appears limited.
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