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A case report of an 80 year old man with mesenteric panniculitis, a raised lactate and hyperglycaemia

Moaize Chechi1, Zeyad Alsallami1, Luke Armstrong1

  • 1General Surgical Department, Bronglais Hospital, Aberystwyth, SY23 1ER, United Kingdom.

International Journal of Surgery Case Reports
|December 3, 2015
PubMed
Abstract

Insights

Mesenteric panniculitis can cause acute abdominal pain, high lactate, and hyperglycemia. This case report suggests steroid treatment is effective for this rare condition, potentially linked to fat necrosis.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pathology

Background:

  • Mesenteric panniculitis is a rare condition characterized by benign inflammatory or fibrotic changes in the bowel mesentery.
  • It often presents with abdominal pain, mimicking other acute abdominal conditions.

Purpose of the Study:

  • To report a unique case of mesenteric panniculitis presenting with acute abdominal pain, hyperglycemia, and elevated lactate.
  • To discuss the potential pathophysiology linking mesenteric panniculitis to these metabolic derangements.
  • To evaluate the efficacy of steroid treatment in this context.

Main Methods:

  • Case report of an 80-year-old male with acute abdominal pain.
  • Diagnostic workup including computed tomography (CT) scan.
  • Biochemical analysis revealing hyperglycemia and high lactate.
  • Treatment with corticosteroids.

Main Results:

  • CT scan confirmed mesenteric panniculitis.
  • The patient experienced rapid symptom resolution following steroid administration.
  • The case highlights an unreported association between mesenteric panniculitis, hyperglycemia, and elevated lactate.

Conclusions:

  • Mesenteric panniculitis can present as an acute abdomen with associated metabolic abnormalities like hyperglycemia and high lactate, possibly due to fat necrosis and ischemia.
  • Further research is warranted to explore the relationship between mesenteric panniculitis, lactate levels, and diabetes.
  • Short-term steroid therapy demonstrated comparable efficacy to long-term treatment in this case.
Keywords:
Abdominal painFat necrosisHyperglycaemiaMesenteric panniculitisRaised lactateSteroids

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