Mesenteric Panniculitis

Mesenteric panniculitis is a benign but chronic inflammatory disease. This rare chronic disease damages the tissue of the mesentery of your colon and small intestine. Your doctor may make use of computed tomography to diagnose this disease, which is then confirmed by surgical biopsies. It is important to point out that mesenteric panniculitis treatment is empirical and there are only a few drugs used for this. Different treatment options work differently for different patients. What works best for one patient may not be that responsive when used for another patient. It is therefore important to consider your mesenteric panniculitis symptoms to be able to identify a suitable treatment regimen.

What Are the Symptoms of Mesenteric Panniculitis?

It is worth mentioning that the condition affects your abdominal area, so your symptoms are also related to this affected system. The most common symptoms include back pain, loss of appetite, abdominal pain, fever, nausea, abdominal fullness, weight loss, passage of blood in the rectum, constipation, and palpable abdominal mass. The symptoms you experience may last anywhere between a few days to a year or so. Even if you are noticing any symptoms at the moment, the condition manifests itself differently in different cases and individuals.

In some cases, you may not experience these symptoms at all. You will need some diagnostic assessment in those cases. You may also find patients who report to experience symptoms such as acute abdominal obstructions or jaundice.

What Are the Causes of Mesenteric Panniculitis?

Unfortunately, the exact cause of mesenteric panniculitis is still unknown to the experts. They have, however, highlighted some predisposing factors that often lead to the development of this inflammatory disease. For instance, it usually affects people who may have undergone a surgery in the past. This may happen due to other inflammatory conditions, such as tumor, which may affect your abdomen in some ways. Similarly, many autoimmune diseases like thyroid disease, SLE, and other related conditions may also contribute to the development of panniculitis. Some other conditions also play a role in the progression of the disease, such as chemical or drug injuries, pancreatitis, avitaminosis, bacterial infection, and leakage of urine or bile.

Sometimes, several other factors also lead to the development of this disease. These factors include heart diseases, gallstones, cirrhosis, peptic ulcer, and abdominal aortic aneurism. Some studies have also found a connection between tobacco smoking and panniculitis. The research shows that this disease affects middle-aged men more than females, and is usually more common in Caucasian males. There is, however, no evidence about the relationship of pediatric patients with this disease.

How Is Mesenteric Panniculitis Diagnosed?

As mentioned earlier, the disease can manifest itself in a number of ways and have several symptoms, which can often be quite misleading, as they look like symptoms of some other underlying conditions like gastritis. However, abdominal computed tomography is the most commonly used method for proper diagnosis. This also aids in identifying the presence of the fat deposits and the tumor pseudo capsule. CT scan isn't that effective in this case because it doesn’t provide with clear impressions. All your doctor may notice is soft tissue mass covered by a mesenteric vessel. The vessel will then turn into collateral vessels when left untreated.

If you have fat around your mesenteric vessels, it is referred as the fats ring sign, which indicate issues related to mesenteric panniculitis. This is what separates it from other conditions of the same origin, such as carcinoid tumor, carcinomatosis, and lymphoma. Your doctor will also consider the appearance of the mesentery in your CT scan.

The MRI is a relatively more effective and accurate way of diagnosing this inflammatory disease. It shows the existence of any fibrous capsule that usually don't show on CT scan or other diagnostic tools. Still, the most accurate way of diagnosing this disease is surgical biopsy, which involves getting a complete histologic analysis. These histological examinations are equally important in confirming the development of mesenteric panniculitis, but they are usually less definitive as compared to the radiologic examinations. Some specific radiologic exams will help identify the presence of panniculitis, but they are not that accurate.

What Are the Treatments for Mesenteric Panniculitis?

You will have to consider the severity of the condition to select a mesenteric panniculitis treatment option. It is important to understand though that there is no universally accepted treatment available yet. Finding the right treatment option is important, but making the correct diagnosis is even crucial.

Your doctor may decide to stick to a therapy, which involves using colchicines, steroids, cyclophosphamide, antibiotics, progesterone, tamoxifen, and much more. Prednisone is an effective choice because it has produced favorable effects in most cases. These drugs are not equally effective in all cases and some people may find these medicines less effective.

If medication therapy doesn't work well, you may have to consider opting for a surgical procedure. This usually happens when you deal with a colostomy. Most medical practitioners don't prefer this option though, because they think surgery may make things worse. In many cases, surgical resection has actually led to the progression of the condition, which has proven life threatening as well. It is important that your doctor pay special attention to your medical history before suggesting any surgery. Unfortunately, radiation therapy is not effective in this case.

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