Nishiya Daisuke, Mikami Tatsuya, Fukuda Shinsaku, Hanabata Norihiro, Sasaki Satoshi, Ebina Satoko, Ishiguro Yoh, Sasaki Yoshihiro, Munakata Akihiro
First Department of Internal Medicine, Hirosaki University School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2007 Aug;104(8):1212-7.
A 79-year-old man was admitted our hospital because of severe abdominal fullness. An abdominal ultrasonography showed a large amount of ascites, and diagnostic puncture detected chylous ascites. An abdominal computed tomography revealed a large amount of ascites and a multinodular mass with calcification in the mesentery of the small intestine. An infectious disease, such as tuberculosis, or malignant tumor was suspected to be the causative disease, but there was no diagnostic evidence in further examinations. Based on clinical features, imaging data and chylous ascites, we searched for case reports and found two similar cases of mesenteric panniculitis. Mesenteric panniculitis was highly suspected in this case, however, histopathological examination was rejected by patient. Therefore, we treated with steroid therapy, which had been reported as effective therapy, and the ascites decreased without recurrence.
一名79岁男性因严重腹胀入院。腹部超声显示大量腹水，诊断性穿刺检测出乳糜性腹水。腹部计算机断层扫描显示大量腹水以及小肠系膜内有一个伴有钙化的多结节肿块。怀疑病因是结核病等传染病或恶性肿瘤，但进一步检查未发现诊断依据。基于临床特征、影像学数据和乳糜性腹水，我们检索了病例报告，发现了两例类似的肠系膜脂膜炎病例。该病例高度怀疑为肠系膜脂膜炎，然而，患者拒绝进行组织病理学检查。因此，我们采用了已报道为有效治疗方法的类固醇疗法进行治疗，腹水减少且未复发。
