Abstract
Mesenteric panniculitis is a chronic non-specific inflammatory disease that arises in the mesenteric adipose tissue with an unknown origin. We herein report a rare case of mesenteric panniculitis in an 11-year-old female. She initially presented abdominal pain with a fever and diarrhea. She looked haggard and showed muscular defense. An abdominal CT scan showed ascites and an abscess in the pelvic cavity. Because we diagnosed the acute abdomen due to adnexitis, we performed an emergency operation. Laparotomy revealed redness and edema of the peritoneum, and multiple small white nodules of mesentery from the sigmoid colon to the pelvic cavity. Although we suspected the peritoneal dissemination of a malignant tumor based on the first impression, we could not find any other changes in the abdomen. Therefore, a biopsy and drainage were performed. After the operation, the pathological diagnosis revealed a small nodule as mesenteric panniculitis. This disease is difficult to diagnose before laparotomy, and is generally diagnosed during operation. Because a conservative therapy is effective for this disease, in the case of a patient who has abdominal symptoms and findings like peritonitis on an abdominal CT scan, this disease should therefore be kept in mind to make a differential diagnosis.
