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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric Panniculitis
Cecilio Azar1, Mohamad Ali Ibrahim2, Zakaria El Kouzi2
1Division of Gastroenterology, Clemenceau Medical Center, Dubai, United Arab Emirates.
Background:
Mesenteric panniculitis (MP) is an uncommon non-neoplastic idiopathic inflammation of adipose tissue, mainly affecting the mesentery of the small intestine, with its etiology remaining largely speculative. The difference in prevalence of MP among females and males varies across multiple studies. In most cases, MP is asymptomatic; however, patients can present with nonspecific abdominal symptoms or can mimic underlying gastrointestinal and abdominal diseases. The diagnosis is suggested by computed tomography and is usually confirmed by surgical biopsies if necessary. Treatment is generally supportive and based on a few selected drugs, namely, nonsteroidal anti-inflammatory drugs or corticosteroids. Surgery is reserved when the diagnosis is unclear, when malignancy is suspected or in the case of severe presentation such as mass effect, bowel obstruction, or ischemic changes.
Summary:
MP is a rare inflammatory condition of the mesentery often asymptomatic but can cause nonspecific abdominal symptoms. Diagnosis relies on computed tomography imaging, with treatment mainly supportive, utilizing medications like nonsteroidal anti-inflammatory drugs or corticosteroids, while surgery is reserved for severe cases or diagnostic uncertainty.
Key Messages:
MP causes abdominal pain, and it is mainly diagnosed with CT scan.
Insights
Mesenteric panniculitis (MP) is a rare, idiopathic inflammation of the mesentery. Diagnosis involves CT scans, with supportive care using anti-inflammatories or corticosteroids, and surgery for severe cases.
Area of Science:
- Gastroenterology
- Abdominal Imaging
Background:
- Mesenteric panniculitis (MP) is an uncommon, non-neoplastic inflammatory condition affecting the small intestine's mesentery.
- Its etiology is largely speculative, with varying reported prevalence between sexes.
- MP is often asymptomatic but can present with nonspecific abdominal symptoms, mimicking other gastrointestinal diseases.
Purpose of the Study:
- To summarize the key aspects of mesenteric panniculitis, including its presentation, diagnosis, and management.
- To highlight the role of imaging and medical interventions in addressing this rare condition.
Main Methods:
- Literature review and synthesis of existing data on mesenteric panniculitis.
- Analysis of diagnostic modalities, primarily computed tomography (CT).
- Evaluation of treatment strategies, including medical and surgical options.
Main Results:
- Mesenteric panniculitis is frequently diagnosed via CT scans.
- Nonspecific abdominal symptoms are common in symptomatic cases.
- Treatment typically involves supportive care with NSAIDs or corticosteroids; surgery is reserved for specific complications or diagnostic challenges.
Conclusions:
- Mesenteric panniculitis requires a high index of suspicion, especially with unexplained abdominal symptoms.
- CT imaging is crucial for diagnosis.
- Management is primarily conservative, with surgical intervention reserved for severe or uncertain cases.
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