Materiały źródłowe

• #1 Sclerosing mesenteritis: a comprehensive clinical review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6174187/

  Sclerosing mesenteritis is a rare disease entity initially described in 1924 with a prevalence reported to be less than 1%. […] The purpose of this article is to provide an overview of the literature relevant to the diagnosis, etiology, and management of this condition in hopes of making physicians aware of this unique condition. […] Symptoms of sclerosing mesenteritis are non-specific, and up to 15% of patients can even be completely asymptomatic when it is found on the imaging performed for some other reasons. […] The initial case series published in the early 1950s did include a large proportion of patients who were diagnosed with sclerosing mesenteritis because of abnormal physical examination findings suggestive of abdominal masses. […] A recently published systematic review of 192 cases of sclerosing mesenteritis revealed the symptomatology as abdominal pain in 78.1%, fever 26.0%, weight loss 22.9%, diarrhea 19.3%, vomiting 18.2%, anorexia 13.5%, constipation 10.9%, bloating 9.4%, malaise 5.7%, nausea 5.7%, pain with eating 4.7%, and fatigue 2.1% of patients.

• #2 Sclerosing mesenteritis: a comprehensive clinical review

  https://atm.amegroups.org/article/view/20473/html

  Sclerosing mesenteritis is a rare disease entity initially described in 1924 with a prevalence reported to be less than 1%. […] The purpose of this article is to provide an overview of the literature relevant to the diagnosis, etiology, and management of this condition in hopes of making physicians aware of this unique condition. […] Symptoms of sclerosing mesenteritis are non-specific, and up to 15% of patients can even be completely asymptomatic when it is found on the imaging performed for some other reasons. […] The most common presenting complaint is abdominal pain. […] A recently published systematic review of 192 cases of sclerosing mesenteritis revealed the symptomatology as abdominal pain in 78.1%, fever 26.0%, weight loss 22.9%, diarrhea 19.3%, vomiting 18.2%, anorexia 13.5%, constipation 10.9%, bloating 9.4%, malaise 5.7%, nausea 5.7%, pain with eating 4.7%, and fatigue 2.1% of patients.

• #3 Ultrasonography-Based Management of Sclerosing Mesenteritis: From Diagnosis to Follow-Up

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8009549/

  Sclerosing mesenteritis (SM) is an idiopathic disorder affecting mesentery, characterized by fat necrosis, chronic inflammation and fibrosis. The diagnosis is suggested by imaging but can be definitely established only by biopsies. […] Taking into account its non-specific manifestations, radiologic imaging plays a key role in the diagnosis of SM; nevertheless, a definite diagnosis can be established only by surgical or imaging-guided biopsies. […] The detection at CT scan of an increase in the mesenteric fat density, named misty mesentery, should be considered the first indication, but non-specific mark of SM. […] Furthermore, US and magnetic resonance imaging (MRI) have also been performed for the diagnosis of SM, but there are fewer studies for these procedures than CT and lack of standardized criteria. […] In conclusion, US could be a sensitive, reliable and non-invasive procedure for the diagnosis and the follow-up of SM.

• #4 Sclerosing mesenteritis: a comprehensive clinical review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6174187/

  Although no definitive gross pathologic criteria have been defined, Kipfer et al. proposed the sclerosing mesenteritis to have three gross pathological clinical categories. […] Given the broad differential and the similar imaging findings of several neoplastic processes, a significant number of patients usually undergo CT guided biopsy to establish the diagnosis. […] A significant variety of medical interventions have been used and reported in the literature to treat this challenging diagnosis. […] In one of the largest studies published to date by Akram et al., they proposed a medical treatment algorithm of using tamoxifen twice daily and a prednisone taper completed over three months.

• #5 Sclerosing mesenteritis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/sclerosing-mesenteritis

  Tests and procedures used to diagnose sclerosing mesenteritis include: […] During a physical exam, a member of your healthcare team looks for clues that may help find a diagnosis. For instance, sclerosing mesenteritis often forms a mass in the upper abdomen that can be felt during a physical exam. […] Imaging tests of the abdomen may show sclerosing mesenteritis. Imaging tests may include computerized tomography (CT) or magnetic resonance imaging (MRI). […] If you’re experiencing sclerosing mesenteritis symptoms, a biopsy may be needed to rule out other diseases and to make a definitive diagnosis. A biopsy sample may be collected during surgery or by inserting a long needle through the skin. […] Before starting treatment, a biopsy can confirm the diagnosis and rule out other possibilities, including certain cancers such as lymphoma and carcinoid.

• #6 Sclerosing mesenteritis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20213811/

  Sclerosing mesenteritis is a condition in which tissue that holds the small intestines in place, called the mesentery, becomes inflamed and forms scar tissue. […] Tests and procedures used to diagnose sclerosing mesenteritis include: […] During a physical exam, a member of your healthcare team looks for clues that may help find a diagnosis. For instance, sclerosing mesenteritis often forms a mass in the upper abdomen that can be felt during a physical exam. […] Imaging tests of the abdomen may show sclerosing mesenteritis. Imaging tests may include computerized tomography (CT) or magnetic resonance imaging (MRI). […] If you’re experiencing sclerosing mesenteritis symptoms, a biopsy may be needed to rule out other diseases and to make a definitive diagnosis. A biopsy sample may be collected during surgery or by inserting a long needle through the skin. […] Before starting treatment, a biopsy can confirm the diagnosis and rule out other possibilities, including certain cancers such as lymphoma and carcinoid.

• #7 Sclerosing Mesenteritis | Abdominal Key

  https://abdominalkey.com/sclerosing-mesenteritis/

  Characteristic Durst [13] Emory [15] Akram [1] Year of publication 1977 1997 2007 Study design Cumulative literature dataa Retrospective, single-centerb Retrospective, single-centerc Study period 19551972 19701993 19822005 No. of cases 68 84 92 Age at diagnosis, yr (range) 53 (782) 60 (2387) Median 64.5 (IQR 5572) Malefemale ratio 1.8:1 1.9:1 2.3:1 Previous abdominal surgery/trauma, n (%) 12 (18) 4/78 (5) 32 (35) Associated conditions, n (%) Rheumatologic disorders N/A 1/78 (1.2) 5 (6) Fibrosis at other sites N/Ad 4 (5) 4 (4) Duration of symptoms, mo (range) N/A (24 h to 2 years) 12 (days to 10 years) N/A Symptoms, n (%) Abdominal pain 46 (68) 27/78 (35) 65 (70) Diarrhea or constipation 11 (16) N/A 33 (41) Bloating/distension N/A N/A 24 (26) Weight loss 10 (15) N/A 21 (23) Nausea and vomiting 22 (32) N/A 18 (21) Fever 11 (16) N/A 5 (6) Physical examination, n (%) Palpable abdominal mass 34 (50) 24/78 (31) 14 (15) Signs of bowel obstruction 22 (32) 24/78 (31) 22 (24) Elevated ESR, n (%) N/A N/A 13 (14) Concurrent other intra-abdominal pathology 17 (25) N/A 17 (18) Malignant disease 4 (6) N/A 7 (8) Nonmalignant disease 13 (19) N/A 10 (10)

• #8 Sclerosing mesenteritis: a comprehensive clinical review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6174187/

  There is no specific laboratory biomarker/test available for the diagnosis of sclerosing mesenteritis although the elevation in inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) has been reported in as high as in 80% of cases. […] Abdominal imaging is the mainstay for the diagnosis of the sclerosing mesenteritis, and the advent of CT scan has drastically improved the diagnostic incidence of sclerosing mesenteritis. […] One of the specific CT scan signs to diagnosis sclerosing mesenteritis is a fat ring sign but presence of pseudo-capsule also raise the suspicion of sclerosing mesenteritis. […] The clinical debate that has persisted pertains to whether sclerosing mesenteritis is representative of three different microscopic pathologic entities or just two.

• #9 Sclerosing mesenteritis: a comprehensive clinical review

  https://atm.amegroups.org/article/view/20473/html

  There is no specific laboratory biomarker/test available for the diagnosis of sclerosing mesenteritis although the elevation in inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) has been reported in as high as in 80% of cases. […] Abdominal imaging is the mainstay for the diagnosis of the sclerosing mesenteritis, and the advent of CT scan has drastically improved the diagnostic incidence of sclerosing mesenteritis. […] One of the specific CT scan signs to diagnosis sclerosing mesenteritis is a fat ring sign but presence of pseudo-capsule also raise the suspicion of sclerosing mesenteritis. […] The clinical debate that has persisted pertains to whether sclerosing mesenteritis is representative of three different microscopic pathologic entities or just two.

• #10 Sclerosing Mesenteritis-Update on Diagnostic and Therapeutic Appr

  https://www.itmedicalteam.pl/articles/sclerosing-mesenteritisupdate-on-diagnostic-and-therapeutic-approach-108510.html

  Sclerosing mesenteritis (SM) is a rare, non-specific inflammatory condition, mainly affecting the benign intestinal mesentery. […] The radiological study, especially computed tomography (CT) and magnetic resonance imaging (MRI) are essential components in the diagnostic evaluation. […] The diagnosis is established by histopathologic study. […] The clinical presentation of SM is varied and its diagnosis requires a high degree of suspicion, because the disease is usually asymptomatic. […] The major signs and symptoms appear to be associated with inflammation and the adjacent organ mass effect. […] The laboratory tests are often normal or discrete non-specific variations feature depending on the seriousness of the painting. […] The radiological study, particularly CT and MRI, are essential components in the diagnostic evaluation, though many of its features are nonspecific.

• #11 Sclerosing mesenteritis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/sclerosing-mesenteritis-1?embed_domain=hackmd.io%25252F%252540yIPUAFeCSL2JsU8smR5nJQ%25252Fbnjhjgjghjghjghfavicon.ico&lang=us

  Sclerosing mesenteritis, also known as mesenteric panniculitis or retractile mesenteritis, is an uncommon idiopathic disorder characterized by chronic non-specific inflammation involving the adipose tissue of the bowel mesentery. […] The Coulier criteria can be used to diagnose sclerosing mesenteritis on CT when 3 of the following criteria are present: mesenteric mass which defines and displaces nearby structures without invading them, inhomogenous fat density within the mass attenuates higher than adjacent retroperitoneal or meso-colonic fat, contains small soft tissue nodes, typically 10 mm, low attenuation fatty „halo sign” surrounds lymph nodes or mesenteric vessels, hyperattenuating pseudocapsule may surround the affected area in the absence of ascites or known malignancy involving the mesentery. […] FDG PET-CT is useful for differentiating between sclerosing mesenteritis and malignant mesenteric involvement.

• #12 RSNA 2021 – CTisus.com CT Scanning

  https://ctisus.com/learning/exhibit/gastrointestinal/333633

  CT of Sclerosing Mesenteritis: A Challenging Diagnosis […] Sclerosing mesenteritis is a rare inflammatory condition of unknown cause that affects the root of the mesentery. The mesenteric fat is involved with a variable amount of inflammation, fatty necrosis, and fibrosis. When the inflammation predominates (so-called mesenteric panniculitis), patients generally present with acute pain. On CT images, mesenteric panniculitis appears as a focal area of increased attenuation within the mesenteric fat surrounded by a pseudocapsule, an appearance that has been described as „the misty mesentery”. Areas of fibrosis within the inflamed fat appear as linear bands of soft-tissue attenuation. […] Sclerosing Mesenteritis: CT Findings […] Retraction and shortening of small bowel mesentery […] Partial or complete SBO

• #13 Sclerosing Mesenteritis-Update on Diagnostic and Therapeutic Appr

  https://www.itmedicalteam.pl/articles/sclerosing-mesenteritisupdate-on-diagnostic-and-therapeutic-approach-108510.html

  The most common finding is a nonspecific mass of soft tissue in the mesentery of the small intestine, which infiltrate the intestinal tissue. […] The ”greasy” ring signal (75-90% of cases) and the tumor pseudocapsule (50-60% of cases), are considered specific findings of this pathology. […] The diagnosis is established by histopathologic study, being the essential biopsy and mandatory on all suspected cases. […] Histologically, the disease progresses in three stages. […] Some studies suggest diagnostic criteria based on radiological and histopathological findings: a) injuries with fat density that configure single, multiple or diffuse masses; b) histological confirmation of fat necrosis with inflammatory infiltrate and/or infiltration by macrophages; c) no evidence of inflammatory bowel disease, pancreatitis or extra-abdominal fat necrosis (suggestive of Weber-Christian disease).

• #14 RSNA 2021 – CTisus.com CT Scanning

  https://ctisus.com/learning/exhibit/gastrointestinal/333633

  Well defined or ill-defined mesenteric mass with soft tissue or mixed fat and soft tissue attenuation […] May encase mesenteric vessels with preservation of fatty collar around the vessels (fat ring sign) […] Punctate or coarse calcifications may be seen. […] Sclerosing Mesenteritis: Differential Diagnosis […] Carcinoid tumor […] Metastatic disease to mesentery […] Lymphoma […] Soft tissue sarcomas […] Weber Christian disease.

• #15 Sclerosing mesenteritis and mesenteric panniculitis – clinical experience and radiological features | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-017-0632-7

  Sclerosing mesenteritis (SM) is sometimes used as an umbrella-term for idiopathic inflammatory conditions in the mesentery. […] The diagnosis is based on histopathology or radiology. Histology was the most reliable diagnostic tool earlier and was considered as the standard for diagnosis and has been used in some major clinical studies. […] The suggestion by Emory et al. that MP is a subgroup of SM has not been questioned. […] The medical records were reviewed and if the diagnosis could be confirmed with histology or radiology, the patients were included. […] Sclerosing mesenteritis was considered histologically confirmed if the pathologist suggested SM or if the clinician concluded the inflammatory changes consistent with SM. […] A subgroup of four patients with mesenteric inflammation and histologically verified SM were identified.

• #16 Sclerosing mesenteritis and mesenteric panniculitis – clinical experience and radiological features | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-017-0632-7

  Although they had extensive radiological findings they did not fulfill the Coulier criteria for MP. […] The term SM was reserved for these patients. […] Atypical radiology with histopathology compatible with SM may represent a separate entity with a more aggressive clinical course. […] We propose that the term SM should be reserved for this condition.

• #17 Ultrasonography-based Management of Sclerosing Mesenteritis | IMCRJ

  https://www.dovepress.com/ultrasonography-based-management-of-sclerosing-mesenteritis-from-diagn-peer-reviewed-fulltext-article-IMCRJ

  Regarding the imaging features, the detection at CT scan of an increase in the mesenteric fat density, named misty mesentery, should be considered the first indication, but non-specific mark of SM. […] Furthermore, US and magnetic resonance imaging (MRI) have also been performed for the diagnosis of SM, but there are fewer studies for these procedures than CT and lack of standardized criteria. […] In conclusion, US could be a sensitive, reliable and non-invasive procedure for the diagnosis and the follow-up of SM.

• #18 Idiopathic sclerosing mesenteritis – Wikipedia

  https://en.wikipedia.org/wiki/Idiopathic_sclerosing_mesenteritis

  In regards to the diagnosis of idiopathic sclerosing mesenteritis, a CT scan which creates cross-section pictures of the affected individuals body, can help in the assessment of the disease. „Misty mesentery” is often used to describe increase in mesenteric fat density in sclerosing mesenteritis. However, it is not specific and can be found in other conditions such as mesenteric oedema, lymphedema, haemorrhage, and presence of neoplastic and inflammatory cells must be excluded. Mesenteric lymph nodes are rarely larger than 10 mm in sclerosing mesenteritis. Larger lymph nodes should prompt further investigations with PET scan or biopsy.[7] […] MRI scan may show an intermediate T1 intensity and variable T2 intensity depending on degree of oedema and fibrosis. Presence of oedema causes high T2 signal while fibrosis causes low T2 signal.[7] […] It often mimics other abdominal diseases such as pancreatic or disseminated cancer.[8] CT scanning is important for making the initial diagnosis.[9]

• #19 Sclerosing mesenteritis | Applied Radiology

  https://appliedradiology.com/articles/sclerosing-mesenteritis

  Another finding that may be observed in sclerosing mesenteritis is the presence of a pseudocapsule surrounding the affected mesentery, seen as a soft tissue density band. […] In suggesting the diagnosis of sclerosing mesenteritis, the absence of factors (such as metastasis, multiple tumor sites, or elevated levels of 5-hydroxyindoleacetic acid in urine, as seen in carcinoid), may aid in narrowing the differential diagnosis. […] The sonographic appearance of sclerosing mesenteritis has been reported as a heterogeneous mass with predominance of both hypoechoic and hyperechoic features. […] Histopathologically, lipid-laden macrophages, known as lipophages, are seen. […] In most cases, the disease has a self-limited course with complete resolution. […] However, it is very difficult to diagnose this entity preoperatively.

• #20 Sclerosing mesenteritis mimicking metachronous peritoneal metastases from descending colon adenocarcinoma | World Journal of Surgical Oncology | Full Text

  https://wjso.biomedcentral.com/articles/10.1186/s12957-017-1214-4

  The results of recently published studies indicate that PET scan findings enable clinicians to differentiate between benign and neoplastic mesenteric processes. […] The prognosis of sclerosing mesenteritis is generally regarded as favorable with supportive treatment. […] In conclusion, it is necessary to excise and examine mesenteric nodules in patients with a history of malignancy to distinguish tumor recurrence from alternative diagnoses, such as sclerosing mesenteritis. […] Sclerosing mesenteritis can mimic peritoneal metastasis from malignancies, and it is necessary to excise and examine a mesenteric nodule developing in patients with a history of malignancy to distinguish recurrence and differential diagnosis such as sclerosing mesenteritis.

• #21 Sclerosing mesenteritis: a comprehensive clinical review

  https://atm.amegroups.org/article/view/20473/html

  Although no definitive gross pathologic criteria have been defined, Kipfer et al. proposed the sclerosing mesenteritis to have three gross pathological clinical categories. […] Given the broad differential and the similar imaging findings of several neoplastic processes, a significant number of patients usually undergo CT guided biopsy to establish the diagnosis. […] A significant variety of medical interventions have been used and reported in the literature to treat this challenging diagnosis.

• #22 Sclerosing mesenteritis as an unusual cause of fever of unknown origin: a case report and review | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-sclerosing-mesenteritis-as-an-unusual-S1807593222018683

  Sclerosing mesenteritis is a rare idiopathic condition characterized by a non-neoplastic inflammatory process in the mesenteric fat. […] The clinical presentation and radiological findings are nonspecific, which renders the condition a diagnostic challenge for surgeons and internists. […] Granulomatous and neoplastic diseases are part of the differential diagnosis for sclerosing mesenteritis on clinical and radiological grounds. […] Therefore, histopathology remains the main diagnostic tool. […] The histological findings are fibrosis, myofibroblasts, and inflammatory cell infiltration of the fatty tissue with degeneration or fat necrosis; aggregations of lipid-laden foamy macrophages are also present. […] The likely causal relationship of the disease and FUO in this case is supported by the lack of any other diagnosis, the confirmatory histological findings of sclerosing mesenteritis, and the remission of fever with nonsteroidal anti-inflammatory drug use and the surgical removal of involved tissue.

• #23 Sclerosing mesenteritis | Applied Radiology

  https://appliedradiology.com/articles/sclerosing-mesenteritis

  The diagnosis is made depending on the extent to which inflammatory or fibrotic components predominate. […] The acute or subacute phase of the disease is termed panniculitis, where fatty degeneration and inflammation is the predominant feature. […] The chronic form, termed retractile mesenteritis, is considered when fibrosis is the dominant feature. […] Myriad CT presentations have been described for sclerosing mesenteritis. […] The typical description includes the presence of a heterogeneous mesenteric mass of soft tissue attenuation, with fibrotic or cystic components. […] Based on CT findings, the differential diagnosis for sclerosing mesenteritis, besides carcinoid tumor, includes carcinomatosis, mesenteric lymphoma, and desmoid tumor. […] The fat-ring sign in cases of panniculitis has been described to aid in differentiating sclerosing mesenteritis from other entities.

• #24 Sclerosing mesenteritis mimicking metachronous peritoneal metastases from descending colon adenocarcinoma | World Journal of Surgical Oncology | Full Text

  https://wjso.biomedcentral.com/articles/10.1186/s12957-017-1214-4

  Sclerosing mesenteritis is a non-neoplastic inflammatory disease that occurs in the bowel mesentery. Distinguishing sclerosing mesenteritis from neoplasms may be difficult because of the clinical and radiographic similarities between the two disease entities. […] In patients suspected of having localized peritoneal metastasis from malignancies, any masses must be sampled by surgical excisional biopsy and subsequently examined to rule out alternative diagnoses, such as sclerosing mesenteritis. […] Sclerosing mesenteritis is sometimes indistinguishable from neoplasms because its manifestations and radiographic findings may be identical to those of malignancies. […] Despite these similarities, sclerosing mesenteritis is treated very differently than malignancies; thus, it is very important that sclerosing mesenteritis is diagnosed correctly so that the disease can be managed adequately.

• #25 Sclerosing Mesenteritis | Abdominal Key

  https://abdominalkey.com/sclerosing-mesenteritis/

  A definite diagnosis of SM can only be made by biopsy and pathologic analysis; however the incidental and often asymptomatic nature does not justify biopsy in most cases. Diagnosis can be made by imaging features, especially CT examination (see Sect. 11.8). The term SM is solely reserved for idiopathic inflammation leading to infiltration of the mesentery and must be differentiated from any alternative causes altering density of the mesenteric fat (misty mesentery) [24, 37, 52, 56, 58]. This includes mesenteric edema, hemorrhage, inflammation (e.g., pancreatitis and other inflammatory diseases of the gastrointestinal tract), retroperitoneal fibrosis (RPF), and neoplasm involving the mesentery including lymphoma and primary mesenteric neoplasm. When fibrosis dominates in SM, imaging features may overlap with carcinoid tumors, desmoid tumors, and peritoneal carcinomatosis. Lymphoma is the most common tumor involving the mesentery and is a challenging differential diagnosis to exclude, particularly in the early stage when bulky lymphadenopathy may still be absent [24, 37]. The halo sign and pseudocapsule favors SM, but can be seen in lymphoma. Any lymphadenopathy outside the mesenteric regions favors early stage lymphoma. Lymphoma will not contain calcifications, unless previously treated [24]. The CT appearance of SM and carcinoid can be identical. Both can appear as an infiltrating mass in the root of the mesentery with desmoplastic reaction and calcifications [7, 23, 24]. The halo sign favors SM, a discrete enhancing bowel mass and hypervascular liver metastases favor carcinoid tumor.

• #26 Frontiers | Sclerosing Mesenteritis, a Rare Cause of Mesenteric Mass in a Young Adult: A Case Report

  https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.722312/full

  Sclerosing mesenteritis (SM) is a rare fibroinflammatory disorder that involves mesenteric adipose tissue, more frequently localized in the small intestine, with an insidious clinical presentation having symptoms related to mass effect, usually resulting in bowel obstruction, mesenteric ischemia, as well as rapid weight loss. […] The diagnosis of sclerosing mesenteritis was made. Our case emphasizes that histology remains pre-eminent for a correct diagnosis of SM, as pre-operative radiological-based diagnosis is non-specific. […] There are no specific laboratory tests for SM; in most of these patients there is an increase in inflammation indices, such as erythrocyte sedimentation (ESR) rate and c-reactive protein (CRP). […] Despite the improvement in imaging methods, the histological evaluation of biopsy and surgical samples remains the gold standard for the diagnosis of SM. […] The main differential diagnoses of SM revolve around GIST (gastrointestinal stromal tumor) and mesenteric fibromatosis. […] Our case emphasizes that histology remains prominent for a correct diagnosis of SM, as preoperative radiological-based diagnosis is non-specific.

• #27 Treatment options for spontaneous and postoperative sclerosing mesenteritis

  https://www.wjgnet.com/1948-9366/full/v8/i11/761.htm

  Sclerosing mesenteritis is a rare pathology with only a few described cases in the literature. The etiology is unclear; however, several potential triggers, including abdominal surgery and abdominal trauma, have been discussed. […] Despite it being a rare disease, sclerosing mesenteritis is an important differential diagnosis in patients after abdominal surgery or patients presenting spontaneously with signs of acute inflammation and abdominal pain. […] The symptoms of sclerosing mesenteritis are mostly unspecific. Hence, it is crucial to rule out other pathologies such as lymphoma, sarcoma, peritoneal mesothelioma, infectious diseases (tuberculosis or histoplasmosis) or amyloidosis. […] Due to the nonspecific clinical presentation, a surgical biopsy is often performed; however, it is rarely actually necessary.

• #28 Idiopathic Sclerosing Mesenteritis: An Extremely Rare Cause of Mesenteric Mass | Dhruv | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/3825/3177

  Overall, most patients will improve over time and if it is secondary to autoimmune conditions, the treatment of the autoimmune condition improves the inflammation in the mesentery. […] Idiopathic sclerosing mesenteritis is a diagnosis of exclusion after ruling out some important causes like autoimmune diseases and malignancy and is usually confirmed by tissue diagnosis. […] Further research is needed to establish the etiology of the disease and proper treatment protocols including medical vs. surgical management and their respective outcomes.

• #29 Treatment options for spontaneous and postoperative sclerosing mesenteritis

  https://www.wjgnet.com/1948-9366/full/v8/i11/761.htm

  Today, based on the increasing use of ultrasonography and CT scan with improved quality, the diagnosis can be established based on imaging and clinical presentation. […] Clinical manifestations are nonspecific and can consist of abdominal pain (70%), diarrhea (25%), weight loss (23%), abdominal muscle defense (50%), rebound tenderness (10%-15%), ascites/chylous (14%) and, in rare cases, fever. […] The only evidence in the treatment of these patients is that, in the case of non-resolving bowel obstruction, surgery is needed. […] However, the symptomatic sclerosing mesenteritis must be treated surgically or with a trial of immunosuppressive medication.

• #30 Sclerosing Mesenteritis: Symptoms, Causes & Diagnosis

  https://tap.health/sclerosing-mesenteritis-symptoms/

  Symptoms can be varied and often mimic other gastrointestinal issues, making diagnosis challenging. […] Early diagnosis is key to successful treatment. […] Diagnosis often involves imaging techniques like CT scans and MRI scans to visualize the thickened mesentery. […] In the Indian subcontinent and other tropical regions, access to advanced imaging and surgical care can be a challenge; therefore, proactive healthcare engagement is crucial. […] Early recognition is crucial for optimal management. […] Diagnosis relies heavily on imaging techniques such as CT scans and MRI, which help visualize the characteristic fatty deposits and inflammation in the mesentery. […] Access to specialized surgical care is a key factor influencing outcomes, particularly in regions with limited healthcare infrastructure.

• #31 Sclerosing Mesenteritis: Symptoms, Causes & Diagnosis

  https://tap.health/sclerosing-mesenteritis-symptoms/

  Early diagnosis and access to appropriate healthcare significantly improve the prognosis for sclerosing mesenteritis in India and other tropical countries. […] Early and accurate diagnosis is critical for appropriate management, improving patient outcomes and quality of life. […] Prompt medical attention ensures that you receive the correct treatment and prevent potential complications.

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