Successful treatment of a patient with retractile mesenteritis with prednisone and azathioprine

A patient with retractile mesenteritis is discussed, who presented with a huge 15 X 15-cm inflammatory mass involving the root of the mesentery. Gradually the patient developed duodenal obstruction for which it was necessary to perform a gastroileostomy. Because of a relentless downhill course with fever, weight loss, general malaise, and fatigue, it was finally decided to treat the patient with prednisone and azathioprine. Upon institution of this treatment there was a steady, progressive clinical amelioration with disappearance of fever, improvement in laboratory findings, and gradual regression of the lesion until it became a well-delineated hard mass that was thought to be the end stage of fibrosis. Early trial with such a treatment, once the diagnosis is firmly established, should be considered.