Abstract
Mesenteric panniculitis is an uncommon pathology, of poorly understood etiology, characterized by progressive inflammation and fibrosis of the small bowel mesentery. This disease has been reported usually after other abdominal surgeries. We present two cases of young male patients who underwent laparoscopic sleeve gastrectomy and developed abdominal symptoms within 45–60 days of surgery. Both were investigated for known post-bariatric complications. While first patient presented (5 months later) at an irreversible stage and died within 8–9 months of primary surgery, in second patient, the disease process could be reversed through early intervention, diagnosis, treatment, and compliance. Mesenteric panniculitis is a rapidly progressive entity, which can be adequately treated by early identification and long-term immune-suppressive therapy.
This is a preview of subscription content, log in via an institution to check access.
References
Anand Bala, Sylvain P Coderre, Douglas RE Johnson, et al., “Treatment of sclerosing mesenteritis with corticosteroids and azathioprine,” Can J Gastroenterol, vol. 15, no. 8, pp. 533–535, 2001, https://doi.org/10.1155/2001/462823.
Sharma P, Yadav S, Needham CM, et al. Sclerosing mesenteritis: a systematic review of 192 cases. Clin J Gastroenterol. 2017;10(2):103–11. https://doi.org/10.1007/s12328-017-0716-5.
Hussein MR, Abdelwahed SR. Mesenteric panniculitis: an update. Expert Rev Gastroenterol Hepatol. 2015;9(1):67–78. https://doi.org/10.1586/17474124.2014.939632.
Tytgat GN, Roozendaal K, Winter W, et al. Successful treatment of a patient with retractile mesenteritis with prednisone and azathioprine. Gastroenterology. 1980;79(2):352–6.
Katsanos KH, Ioachim E, Michail M, et al. A fatal case of sclerosing mesenteritis. Dig Liver Dis. 2004;36(2):153–6. https://doi.org/10.1016/j.dld.2003.07.009.
Daskalogiannaki M, Voloudaki A, Prassopoulos P, et al. CT evaluation of mesenteric panniculitis: prevalence and associated diseases. AJR Am J Roentgenol. 2000;174(2):427–31. https://doi.org/10.2214/ajr.174.2.1740427.
Akram S, Pardi DS, Schaffner JA, et al. Sclerosing mesenteritis: clinical features, treatment, and outcome in ninety-two patients. Clin Gastroenterol Hepatol. 2007;5(5):589–96. https://doi.org/10.1016/j.cgh.2007.02.032.
He H, Zhi M, Zhang M, et al. Sclerosing mesenteritis: multidisciplinary collaboration is essential for diagnosis and treatment. Gastroenterol Res. 2017;10(1):50–5. https://doi.org/10.14740/gr732w.
Genereu T, Bellin MF, Wechsler B, et al. Demonstration of efficacy combining corticosteroids and colchicine in two patients with idiopathic sclerosing mesenteritis. Dig Dis Sci. n41:686–8.
Mazure R, Fernandez MP, Niveloni S, et al. Successful treatment of retractile mesenteritis with oral progesterone. Gastroenterology. 1998;114(6):1313–7. https://doi.org/10.1016/S0016-5085(98)70438-X.
Acknowledgements
1. Dr. Bhuvan, Consultant Radiologist, Wockhardt Hospitals.
2. Dr. Gaurav Gupta, Consultant Gastro-intestinal surgeon, Wockhardt Hospitals
3. Dr. Prakash Jiandani, Consultant Intensivist, Wockhardt Hospitals.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Nasta, A.M., Patel, D., Shrivastav, O. et al. Mesenteric Panniculitis—First Case Series After Bariatric Surgery. OBES SURG 28, 881–885 (2018). https://doi.org/10.1007/s11695-017-3103-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-017-3103-x