Nicholson J A, Smith D, Diab M, Scott M H
Department of Surgery, Whiston Hospital, Whiston, UK.
Ann R Coll Surg Engl. 2010 Sep;92(6):W31-4. doi: 10.1308/147870810X12699662981393. Epub 2010 Jul 7.
Mesenteric panniculitis (also known as mesenteric manifestation of Weber-Christian disease, isolated lipodystrophy and mesenteric lipogranuloma), a benign inflammatory or fibrotic change in the mesentery of the bowel, is a rare diagnosis, particularly in the UK. Some 213 cases have been reported in the world-wide literature, just six from the UK. We present four cases of mesenteric panniculitis in Merseyside and review the literature surrounding this poorly understood phenomenon. Four patients who attended surgical out-patients with vague abdominal symptoms, and in two cases a palpable mass, were sent for abdominal computed tomography (CT) scan. One patient was admitted as an emergency with abdominal pain. In each patient there were clear signs of mesenteric panniculitis, first described in 1924. The 'classical' signs of mesenteric panniculitis seen on CT have been argued by some to be pathognemonic of the disease. In two cases, the patients underwent laparoscopic biopsies to confirm the diagnosis. We discuss the literature relating to mesenteric panniculitis, theories about its aetiology, confirmation of the diagnosis and consider the possibility that it is not actually as rare as we think. We suggest that it is rather under diagnosed due to the relative ignorance of the condition amongst both surgeons and radiologists the UK compared to the US, where mesenteric panniculitis is far more widely reported.
肠系膜脂膜炎（也称为韦-克病的肠系膜表现、孤立性脂肪营养不良和肠系膜脂肪肉芽肿）是肠道系膜的一种良性炎症或纤维化改变，是一种罕见的诊断，在英国尤其如此。全球文献中报道了约213例，其中英国仅有6例。我们报告了默西塞德郡的4例肠系膜脂膜炎病例，并回顾了围绕这一了解甚少的现象的文献。4名因腹部症状模糊而到外科门诊就诊的患者，其中2例可触及肿块，被送去做腹部计算机断层扫描（CT）。1例患者因腹痛作为急诊入院。在每例患者中都有明确的肠系膜脂膜炎迹象，该病于1924年首次被描述。一些人认为CT上所见的肠系膜脂膜炎的“典型”迹象是该病的特征性表现。2例患者接受了腹腔镜活检以确诊。我们讨论了与肠系膜脂膜炎相关的文献、其病因学理论、诊断的确认，并考虑了它实际上可能并不像我们认为的那么罕见的可能性。我们认为，由于与美国相比，英国的外科医生和放射科医生对这种疾病相对缺乏了解，它很可能未得到充分诊断，而在美国，肠系膜脂膜炎的报道更为广泛。
