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Mesenteric panniculitis and urolithiasis

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

Acute right loin pain to groin pain.

Patient Data

Age: 50 years
Gender: Male

Note is made of a small stone at the distal right ureter causing mild hydroureteronephrosis.

Incidental finding of stranding and swollen mesentery containing multiple tissue nodules, with preserved fat around the mesenteric vessels and the soft tissue nodules.

Annotated image

Surrounding each nodules and vessels, but better seen around some, is a ring of un-stranded fat, the so called fat halo or fat ring sign (yellow dotted line).

Distal right ureteric stone (blue arrow) is seen with proximal hydroureter.  

Case Discussion

This case illustrates typical appearances of mesenteric panniculitis with an elegantly demonstrated fat halo sign. 

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