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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
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A severe case of sclerosing mesenteritis
Sofia Costa Corado1, Heitor Almeida1, José Rodrigues Baltazar1
1Serviço de Cirurgia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
BMJ Case Reports
|July 11, 2019
Summary
Sclerosing mesenteritis, a rare condition causing mesenteric fibrosis, can lead to severe small bowel obstruction. Early diagnosis and immunomodulatory treatment improved outcomes in a rapidly progressing case.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Sclerosing mesenteritis is a rare benign condition characterized by chronic inflammation and fibrosis of the mesentery.
- It can present with symptoms mimicking malignancy or inflammatory bowel disease.
Observation:
- A 47-year-old man presented with acute small bowel obstruction due to distal ileum stenosis and mesenteric thickening.
- Initial surgery (enterectomy) was followed by persistent obstruction, necessitating a second laparotomy with ileo-colic resection due to aggravated fibrosing process.
Findings:
- Histological diagnosis confirmed sclerosing mesenteritis with rapid progression.
- The patient showed significant clinical improvement after initiating immunomodulatory therapy.
Implications:
- This case highlights the potential for rapid progression of sclerosing mesenteritis requiring surgical intervention.
- Immunomodulatory treatment may be effective in managing complex or rapidly progressing cases of sclerosing mesenteritis.
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