From the Research
Management of mesenteric panniculitis should primarily focus on symptom relief, with first-line medical treatment being prednisone and tamoxifen, as suggested by the most recent and highest quality study 1. When considering treatment options, it's essential to prioritize the severity of symptoms and the presence of complications.
- For asymptomatic patients, observation is recommended, as the condition may resolve spontaneously.
- For symptomatic patients, corticosteroids, such as prednisone, are the first-line therapy, typically administered at a dose of 40-60mg daily for 1-2 weeks, followed by a gradual taper over 2-3 months.
- Tamoxifen, with its anti-fibrotic properties, can be an effective treatment option, as mentioned in the study 1.
- Symptomatic management includes the use of NSAIDs for pain and discomfort, as well as prokinetics or dietary modifications for gastrointestinal symptoms.
- Surgical intervention is reserved for complications like bowel obstruction, perforation, or when malignancy cannot be excluded, as stated in the study 2. The study 3 also highlights the importance of considering underlying malignancies, especially in patients with a history of cancer. Regular follow-up with imaging every 6-12 months is crucial to monitor disease progression and treatment response, as mesenteric panniculitis can occasionally mask underlying malignancies, as noted in the study 4. Key points to consider in the management of mesenteric panniculitis include:
- The benign nature of the condition, as stated in the study 1
- The importance of symptom relief and addressing underlying causes
- The role of corticosteroids and tamoxifen in treatment
- The need for regular follow-up and monitoring for potential complications or underlying malignancies.