Korean J Gastroenterol.  2011 Oct;58(4):221-225. 10.4166/kjg.2011.58.4.221.

A Case of Idiopathic Sclerosing Mesenteritis with Retroperitoneal Fibrosis

• Bae JH
• Kim SH
• Ahn SB
• Son BK
• Jo YJ
• Park YS
• Jung YM
• Chang YS

• KMID: 1718432
• DOI: http://doi.org/10.4166/kjg.2011.58.4.221

Abstract

Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery. It produces tumor-like masses of the mesentery composed of varying degrees of fibrosis, chronic inflammation, and fat necrosis. It has been described variously as fibrosing mesenteritis, retractile mesenteritis, mesenteric Weber Christian disease, and systemic nodular panniculitis. The etiology and pathogenesis of the disease are as yet unknown, but autoimmune disorder, previous abdominal surgery, trauma, and ischemia could play a role. The clinical features include abdominal pain, vomiting, diarrhea, and constipation. Occasionally, patients with this condition may present with bowel obstruction. Rarely, It can be associated with other idiopathic inflammatory disorders such as retroperitoneal fibrosis, sclerosing cholangitis, and orbital pseudotumors. We report a case of idiopathic sclerosing mesenteritis with retroperitoneal fibrosis in a 58-year-old man.

Keyword

Sclerosing mesenteritis; Retroperitoneal fibrosis; Tamoxifen

MeSH Terms

Anti-Inflammatory Agents/therapeutic use
Antineoplastic Agents, Hormonal/therapeutic use
Diagnosis, Differential
Humans
Laparoscopy
Male
Middle Aged
Panniculitis, Peritoneal/complications/*diagnosis/drug therapy
Prednisolone/therapeutic use
Retroperitoneal Fibrosis/complications/*diagnosis/pathology
Tamoxifen/therapeutic use
Tomography, X-Ray Computed

Figure

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  Fig. 1. Erect abdominal x-ray showed paralytic ileus and fecal stasis.

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  Fig. 2. Abdominal CT finding. It revealed mass like enhancement soft tissue lesion (arrow) along the jejunal mesentery, lymph nodes, mesenteric infiltration, and edematous wall thickening of the jejunum.

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  Fig. 3. Abdominal CT showed enhancement soft tissue lesion around the abdominal aorta (arrow).

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  Fig. 4. Laparoscopy showed severe inflammation and whitish sclerosis of the mesentery with bleeding.

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  Fig. 5. (A) Microscopic finding showed irregular fibrosis with myxoid change and expanding into entrapped fat tissue (H&E, ×100). (B) The fibrous tissue showed proliferation of myofibroblastic cells and infiltration of chronic inflammatory cells (H&E, ×200).

Reference

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