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Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature.

Gu GL, Wang SL, Wei XM, Ren L, Li DC, Zou FX - Cases J (2008)

Bottom Line: The intraoperative biopsy indicated that it was an inflammatory mass.The mass and adhered intestines were removed.After operation, this patient went well and lives without recrudescence at the time we wrote this paper.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Surgery, the General Hospital of Chinese PLA Air force, Beijing 100142, PR China. kzggl@163.com.

ABSTRACT
Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph 1 (original magnification, ×200; HE stain). Photomicrograph 1 shows fat necrosis, sclerosing fibrosis in mesentery mass, and the inflammatory stops abruptly at the edge of bowel wall.
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Figure 3: Photomicrograph 1 (original magnification, ×200; HE stain). Photomicrograph 1 shows fat necrosis, sclerosing fibrosis in mesentery mass, and the inflammatory stops abruptly at the edge of bowel wall.

Mentions: A 52-year-old male patient presented with chronic abdominal pain for about 6 mo and intraabdominal mass for about 1 mo. The abdominal pain, mainly located around navel, was intermittent and mild. The mass, located in the right lower quadrant, was mobile, smooth, rigid and about the size of a fist. The laboratory profile of routine blood test, renal and hepatic function tests were normal. Abdominal CT scan demonstrated a solid soft-tissue mass with calcification in the right lower abdomen, which correlated with small bowel and mesentery (Figure 1). Barium meal examination indicated that distal ileum was tangled without obstruction (Figure 2). For short of experience, the radiologist misdiagnosed this patient with celiac teratoma. So the patient underwent an exploratory laparotomy in our department at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. A few ileums tightly adhered on the mass and showed chronic ischemic condition with scars on the serosal surface; however the involved intestine had no obstruction. The three times intraoperative frozen section indicated that it was an inflammatory mass. The mass and adhered intestines were removed. The biopsy of pathological specimens with paraffin section showed fat necrosis, sclerosing fibrosis, clusters of inflammatory cells and lipid-laden macrophages in mesentery mass; and the inflammatory stopped abruptly at the edge of bowel wall (Figure 3, 4). So this case was diagnosed with sclerosing mesenteritis at last. The patient did not take immuno-suppressor and recovered well after operation without any digestive discomfort. No recurrence of the sclerosing mesenteritis was observed during 4 years of follow-up.


Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature.

Gu GL, Wang SL, Wei XM, Ren L, Li DC, Zou FX - Cases J (2008)

Photomicrograph 1 (original magnification, ×200; HE stain). Photomicrograph 1 shows fat necrosis, sclerosing fibrosis in mesentery mass, and the inflammatory stops abruptly at the edge of bowel wall.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2572604&req=5

Figure 3: Photomicrograph 1 (original magnification, ×200; HE stain). Photomicrograph 1 shows fat necrosis, sclerosing fibrosis in mesentery mass, and the inflammatory stops abruptly at the edge of bowel wall.
Mentions: A 52-year-old male patient presented with chronic abdominal pain for about 6 mo and intraabdominal mass for about 1 mo. The abdominal pain, mainly located around navel, was intermittent and mild. The mass, located in the right lower quadrant, was mobile, smooth, rigid and about the size of a fist. The laboratory profile of routine blood test, renal and hepatic function tests were normal. Abdominal CT scan demonstrated a solid soft-tissue mass with calcification in the right lower abdomen, which correlated with small bowel and mesentery (Figure 1). Barium meal examination indicated that distal ileum was tangled without obstruction (Figure 2). For short of experience, the radiologist misdiagnosed this patient with celiac teratoma. So the patient underwent an exploratory laparotomy in our department at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. A few ileums tightly adhered on the mass and showed chronic ischemic condition with scars on the serosal surface; however the involved intestine had no obstruction. The three times intraoperative frozen section indicated that it was an inflammatory mass. The mass and adhered intestines were removed. The biopsy of pathological specimens with paraffin section showed fat necrosis, sclerosing fibrosis, clusters of inflammatory cells and lipid-laden macrophages in mesentery mass; and the inflammatory stopped abruptly at the edge of bowel wall (Figure 3, 4). So this case was diagnosed with sclerosing mesenteritis at last. The patient did not take immuno-suppressor and recovered well after operation without any digestive discomfort. No recurrence of the sclerosing mesenteritis was observed during 4 years of follow-up.

Bottom Line: The intraoperative biopsy indicated that it was an inflammatory mass.The mass and adhered intestines were removed.After operation, this patient went well and lives without recrudescence at the time we wrote this paper.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Surgery, the General Hospital of Chinese PLA Air force, Beijing 100142, PR China. kzggl@163.com.

ABSTRACT
Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper.

No MeSH data available.


Related in: MedlinePlus