Related Experiment Video
Updated: Jul 16, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
A Clinical Review of Mesenteric Panniculitis
Marianny Sulbaran1, Frank K Chen2, Francis A Farraye1
1Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Abstract:
Mesenteric panniculitis (MP) is a benign condition characterized by chronic inflammation and fibrosis of adipose tissue mainly of the small bowel mesentery. MP is commonly detected incidentally on cross-sectional imaging of the abdomen and can be asymptomatic in up to nearly half of patients. The most frequent clinical symptom reported is abdominal pain, followed by bloating/distention, diarrhea, constipation, vomiting, anorexia, weight loss, fever, malaise, and nausea. On computed tomography, MP is seen as a mass-like area of increased fat attenuation within the small bowel mesentery, usually located in the left upper quadrant of the abdomen. This mass-like area envelops mesenteric vessels and displaces adjacent bowel segments. Lymph nodes are frequently seen within the area of mesenteric abnormality. One of the most common differential diagnoses of MP is lymphoma, and positron emission tomography/computed tomography may be performed if there is suspicion of a concurrent underlying malignancy. Because of the benign nature of MP, treatment decisions should be guided by severity of symptoms and presence of complications. First-line medical treatment is prednisone and tamoxifen. Surgery is reserved for cases of recurrent bowel obstruction. This article provides a review of MP, including its epidemiology, pathophysiology, clinical presentation, imaging findings, and treatment.
Insights
Mesenteric panniculitis (MP) is a benign condition of the small bowel mesentery, often asymptomatic and detected incidentally. Treatment focuses on symptom severity, with prednisone and tamoxifen as first-line options.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Mesenteric panniculitis (MP) is a rare, benign inflammatory condition affecting the small bowel mesentery's adipose tissue.
- It is frequently asymptomatic and incidentally discovered via abdominal imaging.
- MP can mimic malignancy, necessitating careful differential diagnosis.
Purpose of the Study:
- To provide a comprehensive review of mesenteric panniculitis.
- To detail its epidemiology, pathophysiology, clinical presentation, and imaging characteristics.
- To outline current treatment strategies for MP.
Main Methods:
- Review of existing literature on mesenteric panniculitis.
- Analysis of clinical presentations and diagnostic imaging findings, particularly computed tomography (CT).
- Discussion of differential diagnoses, including lymphoma, and the role of positron emission tomography/computed tomography (PET/CT).
Main Results:
- MP presents with chronic inflammation and fibrosis of mesenteric adipose tissue.
- CT typically shows a mass-like area of increased fat attenuation in the mesentery, enveloping vessels.
- Abdominal pain is the most common symptom; treatment involves prednisone and tamoxifen, with surgery reserved for obstruction.
Conclusions:
- Mesenteric panniculitis is a benign entity requiring management based on symptom severity and complications.
- Accurate diagnosis through imaging is crucial to differentiate from malignant conditions.
- Current treatment strategies are primarily medical, with surgical intervention reserved for specific complications.
More Related Videos
03:42Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
07:05Visualization of Neutrophil Extracellular Traps in Mesenteric Venules After Mesenteric Ischemia-Reperfusion Injury via Intravital Microscopy
Published on: September 27, 2024
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:19Pericarditis II: Clinical Features and Diagnostic Tests
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...