Mesenteric panniculitis of the small intestine is a rare entity causing nonspecific inflammation disease in the mesenterium and its differential diagnosis and treatment have not been established as yet. We herein describe a case of mesenteric panniculitis of the small intestine successfully treated by laparoscopy assisted operation and discuss the relevant literature. A 78-year-old man was admitted to the hospital because of ileus symptoms. Double contrast radiography of the small intestine revealed narrowing segment of the small intestine. An abdominal CT scan disclosed thickened wall of the small intestine, and a low density mass in the mesentery near the thickend portion which was enhanced by contrast medium. On laparoscopy, serosa of the small intestine at 1m apart from the Treitz's ligament was spotted reddish edematously in 10cm length, and the mesenteric fat tissue appeared yellow-white in color and hard. We diagnosed it mesenteric panniculitis of the small intestine, and a surgical resection was performed by mini laparotomy at 6cm left pararectus abdominal skin incision. Pathological findings revealed multiple small erosion in the small intestinal mucosa, and hemorrhagic necrosis or granulated change in the mesenteric fat tissue.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)