Discussion Author: Christopher J Bennett
Read more about Mesenteric Panniculitis
mesenteric panniculitis is an idiopathic inflammatory disorder of the small bowel mesentery. Patients may be asymptomatic or may complain of progressive or intermittent abdominal pain, fever, and nonspecific gastrointestinal symptoms. Associations with a variety of benign and malignant disorders have been proposed. However, mesenteric panniculitis may exist as an incidental finding in otherwise normal patients, or it may be seen alone in patients with abdominal pain. Some patients have required steroid therapy for persistent symptoms.
In patients who have gone to biopsy, pathologic findings have been relatively nonspecific and included lipid laden macrophages, lymphocytic infiltrates, and fibrosis of variable severity.
Findings at CT consist of hazy increased attenuation of mesenteric fat, characteristically sparing the fat surrounding blood vessels. The latter finding has been described as a "fatty halo" around vascular structures. A hyperattenuating rind sometimes surrounds the involved mesentery, and soft tissue nodules on the order of several millimeters may be present. In the majority of cases, the involved mesentery lies to the left of midline and extends toward the jejunum. Adjacent bowel loops may be displaced but are otherwise normal. When fibrosis predominates, the disorder is sometimes referred to as retractile mesenteritis.
In this patient, no other abnormalities were identified and there was no evidence of urolithiasis. CT findings of mesenteric panniculitis provided an explanation for his abdominal pain. Noncontrast abdominal or "stone protocol" CT often provides an alternative diagnosis in patients with suspected renal or ureteral calculi. Diverticulitis, inflammatory bowel disease, appendicitis, and adnexal masses are commonly identified as the source of symptoms.
Search for more about Mesenteric Panniculitis