Talwar Ambika, Rayner Hugh
Department of Renal Medicine, Birmingham Heartlands Hospital, Birmingham, UK.
BMJ Case Rep. 2012 Aug 27;2012:bcr1220115443. doi: 10.1136/bcr.12.2011.5443.
An 86-year-old gentleman presented with a 3-month history of nausea, anorexia and excruciating generalised abdominal pain. He had been discharged a week earlier from another hospital. No diagnosis had been made. Clinically the patient was feverish, with a palpable, tender and poorly defined mass in his epigastrium. He had elevated inflammatory markers and deranged electrolytes. An ultrasound scan revealed thickening and hyper echogenicity of the small bowel mesentery. A CT scan was recommended; this revealed a diagnosis of mesenteric panniculitis. First described in 1924, mesenteric panniculitis is a benign inflammatory condition of the bowel mesentery. With only a handful of cases being reported in the UK, the authors thought that they had come across a rarity. This case report focuses on the aetiology, diagnosis, pathology and treatment of mesenteric panniculitis. By examining the literature, the authors also suggest that it is relatively underdiagnosed and may be more common than first thought.
一位86岁的男性患者，出现恶心、厌食和剧烈的全腹痛3个月。他一周前从另一家医院出院，当时未明确诊断。临床检查发现患者发热，上腹部可触及一个压痛明显、边界不清的肿块。他的炎症指标升高，电解质紊乱。超声扫描显示小肠系膜增厚且回声增强。建议进行CT扫描，结果诊断为肠系膜脂膜炎。肠系膜脂膜炎于1924年首次被描述，是一种肠道系膜的良性炎症性疾病。由于英国仅报告了少数病例，作者认为他们遇到了一种罕见疾病。本病例报告重点关注肠系膜脂膜炎的病因、诊断、病理及治疗。通过查阅文献，作者还指出该病相对诊断不足，可能比最初认为的更为常见。
