Sclerosing Lipogranulomatosis: Its Several Abdominal Syndromes

SEVERAL reports concerning chronic inflammatory infiltrations of the small bowel mesentery and retroperitoneum have been published. Xanthogranulomatous obstruction of the colon,¹sclerosing retroperitonitis with ureteral obstruction,²and isolated mesenteric panniculitis³would at first appear to be distinctly separate pathological entities. It is our opinion, however, that each represents a different symptom complex resulting from the same nonspecific tissue reaction. The process seems to begin with a fatty tissue injury which results in a granulomatous cellular reaction followed by fibrosis. The resulting clinical picture is determined by the envelopment and gradual narrowing of the tubular structures that lie within the mass. Gross and microscopic descriptions of tissue obtained from patients with these several afflictions have shown consistent similarities, suggesting that clinical differences are chiefly due to location, extent, and duration of the process. We postulate that these and similar syndromes are manifestations of sclerosing lipogranulomatosis. Report of Cases