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Updated: Mar 7, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Sclerosing mesenteritis: a systematic review of 192 cases
Prabin Sharma1, Siddhartha Yadav2, Christine Marie Needham3
1Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA. prabin.sharma@bpthosp.org.
Introduction:
Sclerosing mesenteritis includes a spectrum of inflammatory disorders involving the adipose tissue of the bowel mesentery.
Aim:
To perform a systematic review of previously reported cases of sclerosing mesenteritis (SM) to determine the epidemiology, risk factors, methods of diagnosis, treatment patterns and outcomes for this disease.
Methods:
Medline, PubMed, Google Scholar and Cochrane database were searched using keywords mesenteric panniculitis, retractile mesenteritis, mesenteric lipodystrophy and sclerosing mesenteritis. Data was collated into a single excel database, transferred into SPSS (Version 21.0) and analyzed.
Results:
Patients diagnosed with SM were between ages of 3 and 88 with a mean age of 55 ± 19.2 years. SM was more common in Caucasians (n = 28, 60.8% of those reporting ethnicity) and men (n = 133, 69.3%) with a male to female ratio of 2.3:1. 28.6% (n = 55) of patients reported a prior abdominal surgery or abdominal trauma, 8.9% (n = 17) had a history of malignancy, and 5.7% (n = 11) of autoimmune disease. 85.4% (n = 164) underwent surgical abdominal exploration (open or laparoscopic); 41.7% (n = 80) had surgery with resection of the involved bowel and mesentery. 34.9% (n = 67) of patients received medical treatment with the majority of them receiving steroids (n = 56, 83.5%). Symptom duration of more than a month (66.7% vs 40.4%, p < 0.05), underlying autoimmune disorder (14.3% vs 4.0%, p < 0.05) or low protein (14.3% vs 4.0%, p < 0.05) at presentation were seen more frequently in those with poor treatment response whereas patients with tender abdomen (45.0% vs 19.0%, p < 0.05) or leukocytosis (20.5% vs 0.0%, p < 0.05) at presentation were likely to have good response to therapy. The most common complications included bowel obstruction/ileus/ischemia (n = 10, 23.8%) and obstructive uropathy/renal failure (n = 10, 23.8%). There were a total of 14 deaths, 12 (85.7%) of which were secondary to SM related complications.
Conclusion:
SM is a poorly understood chronic inflammatory disease. Our study is the first systematic review of the published cases of SM. Future work is required to better understand this disease and its optimal therapy.
Insights
Sclerosing mesenteritis (SM) is a rare inflammatory condition. This systematic review highlights its epidemiology, risk factors, and treatment, emphasizing the need for further research into optimal therapies for this poorly understood disease.
Area of Science:
- Gastroenterology
- Pathology
- Inflammatory Diseases
Background:
- Sclerosing mesenteritis (SM) is a spectrum of inflammatory disorders affecting the bowel's mesenteric adipose tissue.
- This condition is poorly understood, necessitating comprehensive reviews of existing literature.
Purpose of the Study:
- To conduct a systematic review of published sclerosing mesenteritis (SM) cases.
- To determine the epidemiology, risk factors, diagnostic methods, treatment patterns, and outcomes of SM.
Main Methods:
- Systematic literature search of Medline, PubMed, Google Scholar, and Cochrane databases.
- Keywords included various terms for sclerosing mesenteritis.
- Data analysis using SPSS (Version 21.0) after collation into an Excel database.
Main Results:
- SM affects a wide age range (3-88 years, mean 55), predominantly Caucasians and men (2.3:1 ratio).
- Risk factors include prior abdominal surgery/trauma (28.6%), malignancy (8.9%), and autoimmune disease (5.7%).
- Most patients underwent abdominal exploration (85.4%); steroids were the primary medical treatment (83.5% of treated patients). Poor treatment response correlated with longer symptom duration, autoimmune disorders, and low protein; good response with tender abdomen and leukocytosis. Common complications were bowel obstruction and obstructive uropathy/renal failure. Mortality was 14%, primarily due to SM complications.
Conclusions:
- Sclerosing mesenteritis (SM) is a poorly understood chronic inflammatory disease.
- This study represents the first systematic review of published SM cases.
- Further research is crucial for a better understanding and establishing optimal therapeutic strategies for SM.
