Med Princ Pract. 2017;26(6):567-572. doi: 10.1159/000484605. Epub 2017 Oct 26.
The aim of this study was to determine the prevalence of mesenteric panniculitis (MP) and to describe its clinical characteristics, therapy, and outcome.
This retrospective study was carried out among patients with MP based on computed tomography (CT) scans from January 2012 to December 2015. The CT images were reanalyzed by study radiologists to confirm the previous MP diagnosis. Patients were divided into 2 groups, i.e., idiopathic and secondary, based on the presence or absence of associated predisposing factors such as trauma, malignancy, autoimmune disorders, ischemia, or previous abdominal surgery. The clinical characteristics of the 2 groups, as well as treatments, were assessed.
Among the 19,869 CT scans, 36 patients (0.18%) with MP were identified (i.e., 19 [53%] females and 17 [47%] males). The median age was 54 years (range 26 - 76). Twenty-four patients (67%) were categorized into the idiopathic group. Malignancy was the predisposing factor in 8 (22%) of those patients. Furthermore, abdominal pain was the cardinal symptom observed in 22 patients (92%) in the idiopathic group. In the idiopathic group, 15 patients (63%) were treated with antibiotics and 16 (67%) were treated with nonsteroidal anti-inflammatory drugs (NSAID). One unresponsive patient was treated with colchicine. Symptomatic relief was achieved in all of the treated patients.
In this study, a symptomatic idiopathic subgroup of patients with MP did not have any associated disorder. The response to treatment with antibiotics and NSAID was effective in most of the patients. Based on these findings, anti-inflammatory treatments beyond NSAID and surgery should be reserved for patients who are unresponsive to antibiotics and NSAID.
本研究旨在确定肠系膜脂膜炎（MP）的患病率，并描述其临床特征、治疗方法和转归。
本回顾性研究纳入了 2012 年 1 月至 2015 年 12 月期间基于计算机断层扫描（CT）的肠系膜脂膜炎患者。研究放射科医生对 CT 图像进行重新分析，以确认先前的肠系膜脂膜炎诊断。根据是否存在创伤、恶性肿瘤、自身免疫性疾病、缺血或先前的腹部手术等相关诱发因素，将患者分为特发性和继发性两组。评估了两组患者的临床特征和治疗方法。
在 19869 例 CT 扫描中，共发现 36 例（0.18%）肠系膜脂膜炎患者（即 19 例女性[53%]和 17 例男性[47%]）。中位年龄为 54 岁（范围 26-76 岁）。24 例（67%）患者归入特发性组。恶性肿瘤是这组患者的诱发因素之一（8 例，22%）。此外，腹痛是特发性组 22 例患者（92%）的主要症状。在特发性组中，15 例（63%）患者接受抗生素治疗，16 例（67%）患者接受非甾体抗炎药（NSAID）治疗。1 例无效患者接受秋水仙碱治疗。所有接受治疗的患者症状均得到缓解。
在本研究中，特发性肠系膜脂膜炎患者的一个症状性亚组没有任何相关疾病。抗生素和 NSAID 治疗的反应在大多数患者中是有效的。基于这些发现，对于对抗生素和 NSAID 治疗无反应的患者，应保留 NSAID 和手术以外的抗炎治疗。
