From the Research
Mesenteric panniculitis is a rare, benign condition characterized by chronic inflammation and fibrosis of mesenteric adipose tissue, often presenting with nonspecific symptoms such as abdominal pain, nausea, and weight loss, and typically diagnosed through imaging studies and tissue biopsy. The condition is influenced by various factors, including abdominal trauma and surgery, and its exact cause remains unknown, with theories including autoimmune processes, previous abdominal surgery, or trauma 1, 2.
Key Characteristics
- Mesenteric panniculitis is a benign disease that can be asymptomatic in up to nearly half of patients, with the most frequent clinical symptom reported being abdominal pain, followed by bloating/distention, diarrhea, constipation, vomiting, anorexia, weight loss, fever, malaise, and nausea 3.
- The diagnosis of mesenteric panniculitis mainly relies on imaging, such as CT, which shows a characteristic "misty mesentery" appearance, and when indicated, histological confirmation 1, 2.
- Treatment decisions should be guided by the severity of symptoms and the presence of complications, with first-line medical treatment often involving corticosteroids like prednisone and tamoxifen 3, 2.
Management
- For mild cases, observation may be sufficient, but for symptomatic patients, corticosteroids like prednisone (starting at 40mg daily with gradual tapering over several weeks) are often the first-line treatment 3, 4.
- Immunosuppressive medications such as azathioprine (50-150mg daily), cyclophosphamide, or tamoxifen (10-20mg twice daily) may be added for steroid-sparing effects or in refractory cases 3, 4.
- Pain management with NSAIDs or, if necessary, opioid analgesics may be required, and patients should be monitored regularly with abdominal imaging (CT or MRI) every 6-12 months to assess disease progression 3, 2.
Prognosis
- The condition often has a benign course, but treatment aims to prevent complications like bowel obstruction or perforation, and some cases resolve spontaneously, while others may require long-term management of chronic inflammation 1, 2.
- Surgery is reserved for cases of recurrent bowel obstruction, and the purpose of treatment is to systematically introduce and summarize the epidemiology, etiology, histopathology, clinical manifestations, diagnosis, treatment, and prognosis of mesenteric panniculitis, so as to improve the understanding of this disease 2.