A case of mesenteric panniculitis in a 79-year-old man is reported. The patient was admitted to the hospital because of abdominal pain. Physical examination revealed a hard fist-sized mass with tenderness in his left lower abdomen. Barium enema study demonstrated a narrowing extended from the descending to sigmoid colon with a saw-tooth-like appearance. CT scan and US revealed a remarkable thickening of the wall of the descending and sigmoid colon.
He was treated conservatively under a diagnosis of intestinal obstruction due to ischemic colitis, but no symptomatic remission was attained. So we performed an operation. At laparotomy, the wall extending from the descending to sigmoid colon was remarkably thick and firm. He underwent left colectomy and transverse colostomy. Histologically, degeneration and necrosis of fat cells were seen and mesenteric panniculitis was confirmed. After the operation, ileus symptoms improved and be he is doing well.
Mesenteric panniculitis is a rare disease characterized by unspecific inflammation of the mesenterium. In our country, only 52cases of the disease of the colon have been reported so far. A total of 53cases including this case are presented and discussed here.