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Mesenteric panniculitis

Case contributed by Abdulmajid Bawazeer
Diagnosis almost certain

Presentation

Chronic upper abdominal pain.

Patient Data

Age: 50 years
Gender: Male
ultrasound

There is hyper-echoic mass-like lesion surrounding the mesenteric vessels in the mid-line of the abdominal cavity.

ct

There is a well-defined mesenteric mass-like lesion surrounded by fatty stranding in the root of the superior mesenteric vessels associated with sub-centimetric short-axis mesenteric lymph nodes along with the separation of bowel loops.
Opacification of mesenteric vessels and no abnormal bowel enhancement.

Annotated image

The blue arrow = fatty mesenteric mass-like lesion.

The yellow arrow = intervening mesenteric vessels.

Both are well illustrated in abdominal ultrasound and abdominal enhanced CT scan.

Case Discussion

Mesenteric panniculitis most commonly appears as a fatty mass lesion in the small bowel mesentery with surrounding fatty stranding and mesenteric lymph nodes, it is also non-specific which may be related to malignancy, systemic condition or recent surgery.
It also can be suspected by abdominal ultrasound.

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