Mesenteric panniculitis is an uncommon, chronic inflammatory disorder involving the adipose tissue of the mesentery. It can present with non-specific abdominal pain, fever, or gastrointestinal symptoms, and may occasionally progress to abscess formation. We report a case of a middle-aged patient who presented with intermittent left lower abdominal pain for five days, associated with fever and loose stools. Clinical examination revealed abdominal distension and tenderness in the right iliac fossa and umbilical regions. Imaging suggested inflammatory changes in the jejunal mesentery. Exploratory laparotomy revealed panniculitis-like changes in a jejunal loop 20 cm from the duodenojejunal (DJ) flexure and jejunal adhesions with a mesenteric abscess segment 25 cm from the DJ flexure. Resection of the affected segment was performed with an end-to-end jejunal anastomosis. Postoperative recovery was uneventful. Mesenteric panniculitis with abscess formation is rare and poses a diagnostic challenge. Early surgical intervention in symptomatic cases leads to favorable outcomes.
Lakshmanan et al. (Wed,) studied this question.