Diagnosis Mesenteric panniculitis Discussion Mesenteric panniculitis is a nonspecific inflammatory and fibrotic process affecting the fatty tissue of the mesentery. The term retractile mesenteritis has been used to describe this process when the predominant component is fibrosis, and mesenteric lipodystrophy has been applied when the primary component is inflammation. Most cases are idiopathic. The age range of patients is wide with the peak incidence in the sixth and seventh decades. Symptoms are variable and include abdominal pain, fever, nausea, vomiting, and weight loss.
Symptoms often persist for a year or more.
Physical examination may be unremarkable or may reveal abdominal tenderness or a palpable mass. Radiologically, upper gastrointestinal and barium enema examinations may demonstrate displacement of bowel loops by a mesenteric mass with the jejunal mesentery most frequently involved. Bowel loops may be dilated, fixed or narrowed, but complete obstruction is rare. Fibrosis causes retraction of the mesentery. Bowel loop narrowing and spiculation mimic neoplastic disease or carcinoid tumor when the fibrotic component of this process predominates.