A CASE OF MESENTERIC PANNICULITIS OF THE SMALL INTESTINE

Abstract

An 89-year-old man was admitted to the hospital because of abdominal pain and fever. Physical examination revealed the strong rebound tenderness and muscular guarding in the entire abdomen. CT scan of the abdomen revealed increased density throughout the mesenteric fat. A diagnosis of diffuse peritonitis was made and he was operated on. On exploration, a large amount of serous ascites was found and the mesenterium of the small intestine was reddish and swollen. Biopsy of the mesenterium and abdominal drainage were performed with a suspicion of mesenteric panniculitis. The pathological diagnosis of the mesenteric biopsy was mesenteric panniculitis, showing that inflammatory cells had infiltrated into the mesenteric fat. The operation improved the patient's systemic condition. But CT scans of the abdomen revealed an ischemic enteritis of the small intestine in the 13th day after the operation. Blood vessel's dilator and prednisone were reduced the blood level of C-reactive protein (CRP). Mesenteric panniculitis is a rather rare disease of unknown etiology, characterized by nonspecific inflammation. Mesenteric panniculitis is prone to require surgery because it manifests symptoms of diffuse peritonitis. But the conservative treatment is commonly employed. Mesenteric panniculitis must be kept in mind in the diagnosis of acute abdomen of unknown etiology.