Abstract
A 52-year-old man with diabetic nephropathy started peritoneal dialysis (PD) in June 2008. On September 14, 2009, he underwent a medical examination because of abdominal fullness, a low drain volume, and cloudy dialysate. Blood examination did not indicate infection or inflammation. The mesenteric fat tissue appeared as a large, high-density mass on an abdominal computed tomography scan. We assumed that this mass obstructed the flow of the dialysate. Because no specific treatment has been established, we administered antibiotics and steroids. Subsequently, the area of the large mass decreased, and dialysate drainage improved. However, the patient developed repeated bacterial peritonitis, and underdialysis occurred. His dialysis therapy was switched to hemodialysis in May 2010. Thus, although mesenteric panniculitis is a rare disease, it should be considered in the differential diagnosis of PD patients with a low drain volume.