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2017 ; 26
(6
): 567-572
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An Overlooked Potentially Treatable Disorder: Idiopathic Mesenteric Panniculitis
#MMPMID29073610
Sahin A
; Artas H
; Eroglu Y
; Tunc N
; Demirel U
; Bahcecioglu IH
; Yalniz M
Med Princ Pract
2017[]; 26
(6
): 567-572
PMID29073610
show ga
OBJECTIVE: The aim of this study was to determine the prevalence of mesenteric
panniculitis (MP) and to describe its clinical characteristics, therapy, and
outcome. SUBJECTS AND METHODS: This retrospective study was carried out among
patients with MP based on computed tomography (CT) scans from January 2012 to
December 2015. The CT images were reanalyzed by study radiologists to confirm the
previous MP diagnosis. Patients were divided into 2 groups, i.e., idiopathic and
secondary, based on the presence or absence of associated predisposing factors
such as trauma, malignancy, autoimmune disorders, ischemia, or previous abdominal
surgery. The clinical characteristics of the 2 groups, as well as treatments,
were assessed. RESULTS: Among the 19,869 CT scans, 36 patients (0.18%) with MP
were identified (i.e., 19 [53%] females and 17 [47%] males). The median age was
54 years (range 26 - 76). Twenty-four patients (67%) were categorized into the
idiopathic group. Malignancy was the predisposing factor in 8 (22%) of those
patients. Furthermore, abdominal pain was the cardinal symptom observed in 22
patients (92%) in the idiopathic group. In the idiopathic group, 15 patients
(63%) were treated with antibiotics and 16 (67%) were treated with nonsteroidal
anti-inflammatory drugs (NSAID). One unresponsive patient was treated with
colchicine. Symptomatic relief was achieved in all of the treated patients.
CONCLUSION: In this study, a symptomatic idiopathic subgroup of patients with MP
did not have any associated disorder. The response to treatment with antibiotics
and NSAID was effective in most of the patients. Based on these findings,
anti-inflammatory treatments beyond NSAID and surgery should be reserved for
patients who are unresponsive to antibiotics and NSAID.