Mesenteric Panniculitis - NORD (National Organization for Rare Disorders) (2022)

Mesenteric Panniculitis

NORD gratefully acknowledges Eli D. Ehrenpreis, MD, Associate Director for Research, Advocate Lutheran General Hospital Internal Medicine Residency, Park Ridge, Illinois; Professor of Medicine, Rosalind Franklin University Medical School and Jeffery Prochet, MD, Advocate Lutheran General Hospital Internal Medicine Residency, Park Ridge, Illinois for the preparation of this report.

Synonyms of Mesenteric Panniculitis

  • sclerosing mesenteritis
  • mesenteric lipodystrophy
  • retractile mesenteritis

General Discussion

Summary

Mesenteric panniculitis, also known as sclerosing mesenteritis, belongs to a spectrum of rare diseases of the fatty (adipose) tissue of the mesentery. Mesenteric panniculitis is characterized by fat degeneration and necrosis, chronic inflammation, and at times, scarring and fibrosis of fatty tissue within the mesentery. This inflammatory and at times progressive condition is most consistent with autoimmune disorders. There is currently limited understanding of the progression of events that lead to the development of mesenteric panniculitis.

The mesentery is a fold of tissue within the peritoneum that supports and attaches the small and large intestines to the walls of the abdomen. The mesentery contains fat, blood vessels, lymphatic tissue, lymphatic vessels and other forms of connective tissue. Anatomists previously considered it to be a fragmented collection of intra-abdominal connective tissue. Recently, the anatomy of the mesentery has been clarified and the mesentery has been found to represent a continuous organ that extends from the duodenojejunal flexure to the mesorectum. The portion of the mesentery that is adjacent to the small intestine is most often affected in mesenteric panniculitis. Although the exact cause of mesenteric panniculitis remains unknown, the disease has been associated with a variety of other conditions, including neoplasms, other autoimmune diseases and abdominal trauma.

Clinical symptoms of mesenteric panniculitis are highly variable. Some individuals have few or no noticeable symptoms; others may be greatly affected by a variety of complaints including abdominal pain, nausea/vomiting, bloating, early satiety, loss of appetite and diarrhea or constipation. Systemic symptoms, especially fatigue, commonly occur in patients with mesenteric panniculitis. A computerized tomogram (CT) or other imaging of the abdomen shows thickening of the mesentery, sometimes with lymph node enlargement. Due to its variable clinical presentation and rarity, the diagnosis of mesenteric panniculitis is often delayed. Tissue biopsy is required to secure the diagnosis of mesenteric panniculitis and rule out neoplastic infiltration of the mesentery. However, not every patient suspected of having the disease will require a biopsy. There is limited information on the natural history of mesenteric panniculitis, but a stable clinical course is generally anticipated. Due to the rarity of mesenteric panniculitis, there is little prospective data available on its treatment. Nonetheless, corticosteroids and other medications directed at lowering the degree of inflammation and other medications that improve symptoms are felt to be the mainstay of treatment for mesenteric panniculitis.

Introduction

Mesenteric panniculitis is a rare disorder that is part of a spectrum of diseases affecting the mesentery, a continuous organ that extends from the duodenojejunal flexure to the mesorectum that supports and attaches the intestines to the abdominal wall. Individuals with mesenteric panniculitis develop inflammation and necrosis of the fatty tissue of the mesentery, especially in the area of the small bowel. The condition progresses to cause chronic inflammation of the mesentery. In some patients, ongoing inflammation can result in scarring (fibrosis) of the mesentery.

Mesenteric panniculitis was first described in the medical literature in 1924 as “retractile mesenteritis”. Since that time, alternative names have been used to describe the condition including mesenteric panniculitis, retractile mesenteritis and mesenteric lipodystrophy. These names denote the predominant features of the disease process in the mesentery. Mesenteric panniculitis refers to the manifestation of the disease with a predominance of inflammation, sclerosing mesenteritis (or retractile mesenteritis) is the term that refers to a form of the disease with a predominance of fibrosis; and mesenteric lipodystrophy refers to disease with a histologic predominance of fat necrosis.

Emory et al. examined three entities (sclerosing mesenteritis, mesenteric panniculitis, and mesenteric lipodystrophy) and confirmed that there was a great deal of histologic overlap between the three entities and suggested that they are all manifestations of the same condition. The authors of this historic study also concluded that the most appropriate term for the process was “sclerosing mesenteritis” based on the presence of some degree of fibrosis. The authors also hypothesized that the condition might be a progressive process moving from lipodystrophy to mesenteric panniculitis to retractile mesenteritis. At present, mesenteric panniculitis is the most commonly used and recommended name for the condition. Overall, additional names that have been used for this disorder include mesenteric fibrosis, mesenteric sclerosis, liposclerotic mesenteritis, mesenteric Pfeifer-Weber-Christian disease, mesenteric lipogranuloma, xanthogranulomatous mesenteritis, inflammatory pseudotumor, retroperitoneal xanthogranuloma and isolated lipodystrophy.

Signs & Symptoms

In general, mesenteric panniculitis is a chronic, benign disorder with a favorable prognosis that occasionally resolves on its own (spontaneous regression). Nonetheless, symptoms of mesenteric panniculitis may be severe in some patients and can result in significant effects on quality of life. The clinical presentation of mesenteric panniculitis is highly variable. Some patients have few or no noticeable symptoms. The diagnosis of mesenteric panniculitis may be made incidentally following a CT scan of the abdomen, generally for the evaluation of abdominal pain. Symptoms of mesenteric panniculitis fall into two categories. Some symptoms, such as abdominal pain, are due to the mass-like effect of mesenteric inflammation, and potentially involvement of adjacent structures including the small intestine. The second group of symptoms occurs in the presence of chronic inflammation and may include weight loss, fever, and fatigue. Some affected individuals may develop complications such as small bowel obstruction or acute abdomen. Small bowel obstruction prevents the passage of food through the intestines and can cause a variety of nonspecific gastrointestinal symptoms as well as a nutrient malabsorption.

The most common symptom of mesenteric panniculitis is abdominal pain. The pain is generally located in the middle portion of the abdomen but can be present in other areas of the abdomen or pelvis as well. Other common symptoms include nausea, vomiting, early satiety, anorexia, fatigue, fever, unintended weight loss and altered bowel habits (either constipation or diarrhea). In some patients a tender mass may be detected in the middle portion of the abdomen mass. Abdominal distension from chylous ascites has also been described. A thorough examination to rule out peripheral lymphadenopathy or other signs of neoplasm is necessary in all patients.

Causes

There is little information available on the cause of mesenteric panniculitis. Many autoimmune diseases are believed to occur when patients with genetic predisposition to the diseases are exposed to an environmental factor that triggers an inappropriate immunologic response. This response ultimately leads to chronic inflammation. To this end, many conditions have been associated with and possibly predispose to the development of mesenteric panniculitis. These include surgery, acute pancreatitis, other autoimmune conditions and trauma.

Surgery

Multiple papers have cited a relationship between mesenteric panniculitis and abdominal trauma or surgery. A review of the literature suggests a relatively low rate of association (4.76%).

Infections

Multiple case reports of mesenteric panniculitis have detailed the history of chronic infections including tuberculosis, histoplasmosis, Whipple’s disease, typhoid fever, cholera and syphilis that have possibly led to the development of sclerosing mesenteritis.

Autoimmune Diseases

Evidence suggests that mesenteric panniculitis is an autoimmune disorder. Autoimmune diseases occur when the body’s natural defense mechanisms such as antibodies and lymphocytes, (that are normally in place for prevention of infectious diseases and cancer), instead cause a reaction and damage to the patient’s own healthy tissue. In general, genetic and environmental factors play a role in the development of autoimmune diseases. A number of factors support the hypothesis that mesenteric panniculitis is an autoimmune disease. These include the fact that biopsies of affected areas show chronic, ongoing inflammation, (although inflammation is not specific for autoimmune processes).

Additionally, systemic symptoms that are characteristic of other autoimmune diseases such as rheumatoid arthritis and Crohn’s disease including fever and fatigue can occur in patients with mesenteric panniculitis. Patients with mesenteric panniculitis also frequently often have a strong family history of autoimmune diseases. Finally, elevation of inflammatory markers that are measured in the blood, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are often found in patients with mesenteric panniculitis. Because mesenteric panniculitis occurs in some patients after certain medications, infections, abdominal surgery or trauma, other theories have been proposed to explain this disorder including post inflammatory reactions to acute inflammation or infection, or a deficient blood supply (ischemia) to the mesentery. However, these conditions probably develop secondary to an autoimmune reaction.

Neoplastic Diseases

A significant number of patients with radiographically diagnosed “mesenteric panniculitis” have a variety of known or soon to be diagnosed cancers. A case control study from 2013 suggested that the appearance of “mesenteric panniculitis” often represents a paraneoplastic process. A significant number of patients having mesenteric abnormalities consistent with mesenteric panniculitis on CT scan will have an underlying form of cancer. The most common cancers with mesenteric panniculitis like abnormalities on CT scan are lymphomas. Other cancers associated with this finding include carcinoid tumor, colon, renal and prostate cancers. Mesenteric thickening and inflammation often appeared to represent a paraneoplastic syndrome that was not due to the physical presence of cancerous tissue in the affected area. In one study, few of the areas owed increased uptake in positron emission scanning and these abnormalities were generally stable in patients with cancer.

Other Fibrosing Conditions

There is also a known association between mesenteric panniculitis and other fibro-sclerotic disorders. This suggests that mesenteric panniculitis belongs to a larger spectrum of diseases in which inflammation and fibrosis affect multiple organ systems of the body. Fibro-sclerotic disorders that have been reported to occur with mesenteric panniculitis include retroperitoneal fibrosis, Sjögren’s syndrome and sclerosing pancreatitis.

Affected Populations

The epidemiology of mesenteric panniculitis has not been fully defined. One study reported that findings consistent with mesenteric panniculitis occurred in 359 patients (0.24%) from a total of 147,794 abdominal computed tomography (CT) examinations undertaken for over a 5-year period in a large community based medical system. Of these, 100 patients (28%) had known malignancy or were later diagnosed with cancer. The incidence of mesenteric panniculitis from recent studies has shown a range from 0.16% – 3.4%. This range is dependent on the method of diagnosis and whether it is histologic versus radiologically diagnosed.

In some reports, mesenteric panniculitis has a male predominance of 2:1. Mesenteric panniculitis most often appears during the sixth and seventh decade of life, and its incidence appears to increase with age. Children and adolescents are rarely affected, possibly related to a lesser amount of fat in their mesentery, but more importantly because of specific characteristics of this form of autoimmunity.

Diagnosis

The diagnosis of mesenteric panniculitis is made based upon identification of suggestive symptoms, a detailed patient history, and a thorough clinical evaluation.

Clinical Testing and Work-Up
Affected individuals may have non-specific laboratory abnormalities such as reduced red blood cell counts (anemia). Laboratory markers of inflammation such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) can also be elevated.

Radiographic Diagnosis
These five diagnostic signs that have been felt to be specific for mesenteric panniculitis and separate it from other causes of abdominal masses include the presence of a well-defined “mass effect” on neighboring structures (sign 1) constituted by mesenteric fat tissue of inhomogeneous higher attenuation than adjacent retroperitoneal or meso-colonic fat (sign 2) and containing small soft tissue nodes (sign 3). It may typically be surrounded by a hypo-attenuated fatty “halo sign” (sign 4) and a hyperattenuating pseudo-capsule may also surround the entity (sign 5). However, these diagnostic criteria were not histologically verified, but they have overall come to represent the closest general standards available.

Radiographic studies such as computerized tomography (CT) scanning or magnetic resonance imaging (MRI) reveal characteristic findings in the abdominal or pelvic mesentery. Imaging reveals characteristic thickening, fat necrosis and calcification of the mesentery. Mild cases are referred to a “misty mesentery”. Enlargement and calcification of mesenteric and pelvic lymph nodes are commonly present. Because mesenteric panniculitis is not an invasive disorder, blood vessels within the mesentery appear to be spared from the inflammatory mass. This is referred to as the “halo sign” and is highly characteristic of mesenteric panniculitis as opposed to malignancy of the mesentery.

Surgical biopsy and microscopic study of affected tissue is required to completely rule out other conditions and to confirm a diagnosis of mesenteric panniculitis.

Standard Therapies

Treatment
Most treatment recommendations are based on case reports or small case series. The only clinical prospective study of a treatment for mesenteric panniculitis has been performed using the drug thalidomide. The goals of treatment for mesenteric panniculitis are reduction of mesenteric inflammation and the control of symptoms of the disease.

Generally, individuals with no symptoms are not treated, but are regularly monitored to see whether the disorder progresses on abdominal imaging (watch and wait approach). A decision regarding biopsy is made during this time. In most patients, the disease remains asymptomatic. The mesenteric mass is generally stable or even regresses on its own.

For patients with symptoms related to chronic mesenteric inflammation, anti-inflammatory agents, especially corticosteroids are the initial treatment of choice. Additional anti-inflammatory drugs that have been used to treat mesenteric panniculitis include colchicine, azathioprine, cyclophosphamide, infliximab and pentoxifylline. A prospective clinical trial has demonstrated that the drug thalidomide improves symptoms and reduces blood levels of ESR and CRP in patients with mesenteric panniculitis. Low dose naltrexone (LDN) is also a promising new therapy for mesenteric panniculitis. LDN appears to work by modulating the immune system and by increasing blood levels of enkephalins and endorphins. Tamoxifen and other hormonal therapies have been proposed to treat patients with mesenteric fibrosis due to their anti-fibrotic effects. Unfortunately, serious side effects may occur with these medications including the development of thromboembolic phenomena and secondary malignancies. Because of the rarity of mesenteric panniculitis, few controlled clinical studies of medical therapies for this condition are likely to be performed in the future.

When individuals with mesenteric panniculitis develop small intestinal obstruction, surgery may be required. In general, surgery should be avoided in patients with mesenteric panniculitis and there should never be an attempt to surgically remove the mesenteric mass for the purpose of curing the disease.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov . All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: [emailprotected]

Some current clinical trials also are posted on the following page on the NORD website: https://rarediseases.org/for-patients-and-families/information-resources/news-patient-recruitment/

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

For information about clinical trials conducted in Europe, contact:
https://www.clinicaltrialsregister.eu/

Supporting Organizations

References

TEXTBOOKS
Ginsburg PM, Ehrenpreis ED. Mesenteric Panniculitis In: NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:350.

JOURNAL ARTICLES
Green MS, Chhabra R, Goyal H. Sclerosing mesenteritis: a comprehensive clinical review. Ann Transl Med. 2018;6(17):336.

Cross AJ, McCormick JJ, Griffin N, Dixon L, Dobbs B, Frizelle FA. Malignancy and mesenteric panniculitis. Colorectal Dis. 2016 Apr;18(4):372-7.

Roginsky G, Mazulis A, Ecanow JS, Ehrenpreis ED. Mesenteric Panniculitis Associated With Vibrio cholerae Infection. ACG Case Rep J. 2015 Oct 9;3(1):39-41.

Roginsky G, Alexoff A, Ehrenpreis ED. Initial Findings of an Open-Label Trial of Low-Dose Naltrexone for Symptomatic Mesenteric Panniculitis. J Clin Gastroenterol. 2015 Oct;49(9):794-5.

Ö Gögebakan, T. Albrecht, M. A. Osterhoff, A. Reimann. Is mesenteric panniculitis truely a paraneoplastic phenomenon? A matched pair analysis. Eur J Radiol. 2013 Nov; 82(11): 1853–1859.

Smith ZL, Sifuentes H, Deepak P, Ecanow DB, Ehrenpreis ED. Relationship between mesenteric abnormalities on computed tomography and malignancy: clinical findings and outcomes of 359 patients. J Clin Gastroenterol. 2013 May-Jun;47(5):409-14.

Canyigit M, Koksal A, Akgoz A, Kara T, Sarisahin M, Akhan O. Multidetector-row computed tomography findings of sclerosing mesenteritis with associated diseases and its prevalence. Jpn J Radiol. 2011 Aug;29(7):495-502.

Coulier B. Mesenteric panniculitis. Part 2: prevalence and natural course: MDCT prospective study. JBR-BTR. 2011 Sep-Oct; 94(5): 241–246.

Vlachos K, Archontovasilis F, Falidas E, et al. Sclerosing mesenteritis: diverse clinical presentations and dissimilar treatment options. A case series and review of the literature. Int Arch Med. 2010;4:17. http://www.ncbi.nlm.nih.gov/pubmed/21635777

Rees JR, Burgess P. Benign mesenteric lipodystrophy presenting as low abdominal pain: a case report. J Med Case Reports. 2010;4:119. http://www.ncbi.nlm.nih.gov/pubmed/20423496

Viswanathan V, Murray KJ. Idiopathic sclerosing mesenteritis in paediatrics: report of a successfully treated case and a review of literature. Pediatr Rheumatol Online J. 2010;8:5. http://www.ncbi.nlm.nih.gov/pubmed/20205836

Kara T, Canyigit M. Relationship between abdominal trauma or surgery and mesenteric panniculitis. World J Gastroenterol. 2009 Dec 28;15(48):6139.)

Kasporitakis AN, Rizos CD, Delikoukos, etal. Retractile mesenteritis presenting with malabsorption syndrome. Successful treatment with oral pentoxifylline. J Gastrointestin Live Dis. 2008;17:91-94. http://www.ncbi.nlm.nih.gov/pubmed/18392253

Akram S, Pardi DS, Schaffner JA, Smyrk TC. Sclerosing mesenteritis: clinical features, treatment, and outcome in ninety-two patients. Clin Gastroenterol Hepatol. 2007;5:589-596. http://download.journals.elsevierhealth.com/pdfs/journals/1542-3565/PIIS1542356507002248.pdf

Ginsburg PM, Ehrenpreis ED. A pilot study of thalidomide for patients with symptomatic mesenteric panniculitis. Aliment Pharmacol Ther. 2002;16:2115-22. http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2002.01383.x/pdf

T. S. Emory, J. M. Monihan, N. J. Carr, L. H. Sobin. Sclerosing mesenteritis, mesenteric panniculitis and mesenteric lipodystrophy: a single entity? Am J Surg Pathol. 1997 Apr; 21(4): 392–398.

Years Published

1988, 1989, 2000, 2011, 2016, 2020

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FAQs

How do you get rid of mesenteric panniculitis? ›

Corticosteroids, drugs that reduce inflammation, are the first line of treatment for mesentery panniculitis, and they often do the trick. In some cases, your healthcare provider may prescribe additional medications to treat side effects of the condition like nausea.

Is mesenteric panniculitis serious? ›

Mesenteric panniculitis typically isn't life-threatening. It may go away on its own, or it could develop into a severe disease. But while the inflammation is there, it can cause pain and other symptoms that interfere with your life. Your doctor can give you medicine to manage this inflammation and control symptoms.

Can panniculitis be cancerous? ›

Complications and related conditions

Mesenteric panniculitis is usually benign, meaning the condition itself is not dangerous or cancerous. However, complications can occur. Severe inflammation can cause slowing and blockages in the intestines. This can make other symptoms worse, such as nausea and bloating.

What does mesenteric panniculitis feel like? ›

Clinical symptoms of mesenteric panniculitis are highly variable. Some individuals have few or no noticeable symptoms; others may be greatly affected by a variety of complaints including abdominal pain, nausea/vomiting, bloating, early satiety, loss of appetite and diarrhea or constipation.

Can panniculitis cause death? ›

The Weber-Christian syndrome (relapsing nodular panniculitis) displays a clinical spectrum varying from short, self-limited, or intermittent disease episodes to persistent disease with fatal outcome.

What foods should I avoid with mesenteric lymphadenitis? ›

Do not eat raw or undercooked chicken, turkey, seafood, beef, or pork. Drink safe water. Drink only treated water. Do not drink water from ponds or lakes.

What medications can cause panniculitis? ›

Cases of drug-induced panniculitis which appear throughout the literature are typically associated with oral contraceptives, NSAIDs, antibiotics, and leukotriene-modifying agents.

Is panniculitis permanent? ›

Panniculitis often resolves without treatment, but certain methods can speed up recovery. The best treatment is to tackle the underlying cause. If there is no known cause, doctors may treat panniculitis by reducing the inflammation, and in some cases, surgically removing the bumps or affected areas of skin.

How common is mesenteric panniculitis? ›

First described by Jura in 1924, mesenteric panniculitis is a relatively common, but rarely reported, benign condition affecting the mesentery of the bowel; characterised by the presence of fat necrosis, chronic inflammation and fibrosis.

How does panniculitis start? ›

Panniculitis is an inflammation of the fat beneath the outer layer of skin, leaving the area red and tender. In this case, the panniculitis has occurred due to exposure to cold. Ice crystals can form within cells and the injury to the cells occur during both cooling and thawing.

What bacteria causes panniculitis? ›

Common bacteria that cause panniculitis include:
  • Streptococcus pyogenes.
  • Staphylococcus aureus.
  • Pseudomonas spp.
  • Klebsiella spp.
  • Nocardia spp.
  • Brucella spp.

Can Covid cause mesenteric panniculitis? ›

Mesenteric panniculitis is a rare idiopathic inflammatory condition involving the mesenteric adipose tissue. The case shed a light on the possible association of COVID-19 with mesenteric panniculitis.

Is mesenteric panniculitis cancerous? ›

1 Introduction. Mesenteric panniculitis (MP) is a non-neoplastic, localized fibro-inflammatory condition which affects the adipose tissue of the small bowel mesentery.

What can cause mesenteric inflammation? ›

The most common cause of mesenteric lymphadenitis is a viral infection, such as gastroenteritis — often called stomach flu. This infection causes inflammation in the lymph nodes in the thin tissue that attaches your intestine to the back of your abdominal wall (mesentery).

What does mesenteric mean? ›

/ˌmes.ənˈter.ɪk/ uk. /mes.ənˈter.ɪk/ relating to the mesentery (= the membrane that connects the bowel to the back wall of the abdomen): the inferior mesenteric artery.

Is mesenteric panniculitis curable? ›

Mesenteric panniculitis resolves spontaneously in most cases, however, palpable masses may often be found between 2 and 11 years after diagnosis, especially in patients with associated comorbidity[6]. In such cases, several types of treatment have been proposed but no consensus has been established.

What causes mesenteric panniculitis? ›

Currently, there's no specific known cause of mesenteric panniculitis. Experts believe that the condition could be due to abdominal surgery, an autoimmune disease (immune cells start attacking the body), or bacterial infection. Mesenteric panniculitis causes persistent and long-term inflammation in the mesentery.

Is coffee good for lymph nodes? ›

Avoid diuretics (“water pills”), alcohol and caffeine.

They both could dilate the lymph tissue and cause more swelling, and as a result, exacerbate the lymphedema.

What fruits help the lymphatic system? ›

Citrus. Citrus fruits aid hydration, carry powerful antioxidants and enzymes, and help cleanse and protect the lymphatic system.

What foods heal lymph nodes? ›

Foods for swollen lymph nodes

Eat simple alkalizing foods such as chicken or bone broth, miso soup, vegetable juices, and steamed green leafy vegetables. This will be easier on the digestive system, help with liver detoxification, reduce acid, boost immunity and add anti-oxidants to the body.

Is panniculitis infectious? ›

This type of panniculitis can occur as a primary infection by direct inoculation of infectious microorganisms into the subcutaneous tissue, or secondarily via microbial hematogenous dissemination with subsequent infection of the subcutaneous tissue. Panniculitis is rarely viewed solely in terms of infectious causes.

How do you test for panniculitis? ›

To diagnose panniculitis, your doctor will examine your skin and ask about your medical history and symptoms. Your doctor will likely remove a small piece of your skin, which is called a biopsy. The tissue sample will go to a lab to be checked under a microscope for inflammation and other signs of panniculitis.

What happens if the mesentery is damaged? ›

In mesenteric ischemia, a blockage in an artery cuts off blood flow to a portion of the intestine. Mesenteric ischemia (mez-un-TER-ik is-KEE-me-uh) occurs when narrowed or blocked arteries restrict blood flow to your small intestine. Decreased blood flow can permanently damage the small intestine.

Is mesenteric panniculitis an inflammatory bowel disease? ›

Mesenteric panniculitis (MP) is mostly an associated sign of an intra-abdominal or systemic inflammatory primary disease.

Where is panniculitis found? ›

The most common place for panniculitis to occur is on the lower legs (shins and calves) and feet. It can develop on other areas of the body, including the hands and arms, thighs, buttocks, abdomen, breasts, or face.

Where is your mesentery? ›

The mesentery is a fold of membrane that attaches the intestine to the abdominal wall and holds it in place.

Can panniculitis be cured? ›

Treatment for Panniculitis. There is no one treatment for panniculitis. Because there are so many different causes, treatment can vary from case to case. Usually, if panniculitis is caused by an underlying condition, you and your doctor will focus on developing a treatment plan for that condition.

Is panniculitis permanent? ›

Panniculitis often resolves without treatment, but certain methods can speed up recovery. The best treatment is to tackle the underlying cause. If there is no known cause, doctors may treat panniculitis by reducing the inflammation, and in some cases, surgically removing the bumps or affected areas of skin.

What causes inflammation of the mesentery? ›

The most common cause of mesenteric lymphadenitis is a viral infection, such as gastroenteritis — often called stomach flu. This infection causes inflammation in the lymph nodes in the thin tissue that attaches your intestine to the back of your abdominal wall (mesentery).

How do you treat an inflamed mesenteric lymph node? ›

Mesenteric lymphadenitis often gets better without treatment. Still, you may need medicine to reduce a fever or control pain. Rest, fluids, and warm heat applied to the abdomen may also help relieve symptoms. You may need treatment for the cause of the inflammation.

Who treats mesenteric panniculitis? ›

In conclusion, mesenteric panniculitis is a rare clinical entity that occurs independently or in association with other disorders. Diagnosis of this nonspecific, benign inflammatory disease is a challenge to gastroenterologists, radiologists, surgeons and pathologists.

What medications can cause panniculitis? ›

Cases of drug-induced panniculitis which appear throughout the literature are typically associated with oral contraceptives, NSAIDs, antibiotics, and leukotriene-modifying agents.

How many cases of mesenteric panniculitis are there? ›

Mesenteric panniculitis is of particular interest to surgeons as it has been shown to be the cause of chronic abdominal pain when other diagnoses have been excluded. There have been 213 case reports in the world-wide literature with a preponderance of cases in the US, France and Japan.

What bacteria causes panniculitis? ›

Common bacteria that cause panniculitis include:
  • Streptococcus pyogenes.
  • Staphylococcus aureus.
  • Pseudomonas spp.
  • Klebsiella spp.
  • Nocardia spp.
  • Brucella spp.

Is panniculitis an infection? ›

This type of panniculitis can occur as a primary infection by direct inoculation of infectious microorganisms into the subcutaneous tissue, or secondarily via microbial hematogenous dissemination with subsequent infection of the subcutaneous tissue. Panniculitis is rarely viewed solely in terms of infectious causes.

Can Covid cause panniculitis? ›

In our patient, the temporal correlation and the absence of other possible triggers suggest that the eosinophilic panniculitis was secondary to COVID-19 infection. The patient had not received subcutaneous heparin injections nor any other specific treatments before the appearance of the lesions.

Is panniculitis serious? ›

Mesenteric panniculitis typically isn't life-threatening. It may go away on its own, or it could develop into a severe disease. But while the inflammation is there, it can cause pain and other symptoms that interfere with your life. Your doctor can give you medicine to manage this inflammation and control symptoms.

What organs are suspended by mesentery? ›

The mesentery attaches the intestines to the abdominal wall, and also helps storing the fat and allows the blood and lymph vessels, as well as the nerves, to supply the intestines.

Can mesentery be removed? ›

Regardless of how the mesentery is classified it is an important part of the human body and integral to the health of the intestines and gastrointestinal tract. While parts of the mesentery may be removed due to illness or injury, removing the entire mesentery is not possible.

What does mesenteric mean? ›

/ˌmes.ənˈter.ɪk/ uk. /mes.ənˈter.ɪk/ relating to the mesentery (= the membrane that connects the bowel to the back wall of the abdomen): the inferior mesenteric artery.

Where is the mesenteric node located? ›

Lymph nodes are present in the mesentery of the right lower quadrant (arrowhead) along with stranding of the mesenteric fat (short arrow), which reflects the inflammatory process.

How painful is mesenteric lymphadenitis? ›

If your child has mesenteric lymphadenitis, they will experience mild pain like a throbbing sensation in the lower right part of their belly or in other areas of their abdomen. This pain can be accompanied by flu-like symptoms and feeling sick. A heating pad or warm compress can help your child's stomach pain.

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