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Mesenteric panniculitis

Case contributed by Bálint Botz
Diagnosis almost certain

Presentation

Vague, chronic abdominal dyscomfort.

Patient Data

Age: 90 years
Gender: Male
ultrasound

Inhomogenously increased echogenicity of the mesenteric fat, with geographic regions of lower echogenicity. Relatively increased vascularity also noted. 

Other: bilateral chronic kidney disease, small renal cysts, enlarged and inhomogenous prostate, moderate hepatic steatosis. 

ct
  • geographic mesenterial fat stranding which appears to be centered around small lymph nodes. 
  • about 15 mm hypodense lesion between the body of the pancreas and the stomach, possible IPMN. Further assessment with MRI warranted (patient was lost to follow-up). 
  • other: CKD with cysts, prostate enlargement. 

Case Discussion

Mesenteric panniculitis can be perplexing on US, and can be hard to differentiate from more sinister pathologies The fat ring sign is well demonstrated by this case. 

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