Abstract
A woman in her 30s was referred to our department with suspected acute appendicitis. Abdominal CT showed a thickened wall of the terminal ileum and a high-density lesion in the mesentery. The patient was diagnosed as having bacterial terminal ileitis and started on treatment with antibiotics, which were, however, not effective. Although repeat CT and abdominal USG showed a reduction in the degree of thickening of the intestinal wall, the inflammation of the mesentery was worse as compared to that in the previous CT. Based on the above, a final diagnosis of mesenteric panniculitis was made. The abdominal pain gradually shifted from the right lower to the left upper abdomen. Follow-up CT confirmed the mesenteric inflammation in the left upper abdomen. As no symptomatic improvement was obtained with antibiotic therapy, the treatment was switched to adrenal steroids. The steroids therapy proved very effective, with the patient's symptoms improving even from the day after initiation of therapy. Herein, we have reported a case of mesenteric panniculitis presenting with migrating abdominal pain. Conservative treatment is possible with steroids.
