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05:07
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
586
Sclerosing Mesenteritis: A Concise Clinical Review for Clinicians.
Bibek Saha1, June Tome2, Xiao Jing Wang2
1Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Mayo Clinic Proceedings
|May 3, 2024
Summary
Sclerosing mesenteritis (SM) is a rare condition causing abdominal issues due to inflammation and fibrosis. Diagnosis often uses CT scans, with tamoxifen and prednisone as primary treatments for symptomatic cases.
Area of Science:
- Gastroenterology
- Abdominal Imaging
- Pathology
Background:
- Sclerosing mesenteritis (SM) is an idiopathic, non-neoplastic condition characterized by chronic inflammation, fibrosis, and fat necrosis, primarily affecting the small intestine's mesentery.
- It typically presents in the fifth or sixth decade, with potential risk factors including prior abdominal surgery and autoimmune diseases.
- While often asymptomatic, SM can manifest with abdominal pain, weight loss, diarrhea, and complications like bowel obstruction and mesenteric vessel thrombosis.
Purpose of the Study:
- To provide a comprehensive overview of sclerosing mesenteritis (SM), covering its epidemiology, clinical presentation, diagnostic approaches, and management strategies.
- To highlight the shift in diagnostic practices from biopsy to computed tomography (CT) imaging for SM.
- To discuss the differential diagnoses, treatment options, and prognosis of SM.
Main Methods:
- Review of existing literature on sclerosing mesenteritis (SM).
- Analysis of diagnostic modalities, emphasizing the role of computed tomography (CT) imaging.
- Evaluation of current pharmacotherapy and surgical interventions for symptomatic or complicated SM.
Main Results:
- Sclerosing mesenteritis (SM) affects 0.18% to 3.14% of the population, with diagnosis shifting towards CT imaging over biopsy.
- Common symptoms include abdominal pain, weight loss, and diarrhea; complications involve bowel obstruction and mesenteric thrombosis.
- First-line treatment for symptomatic SM involves tamoxifen and prednisone, though no randomized controlled trials support this regimen.
Conclusions:
- Sclerosing mesenteritis (SM) is a rare condition with varied presentations, often diagnosed via CT imaging.
- While generally benign, SM can progress and lead to fatal outcomes in some cases.
- Management focuses on symptomatic relief and preventing complications, with tamoxifen and prednisone as the current standard pharmacotherapy.
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