Rodrigues Miguel E, Pinheiro João Luís, Barbosa Bruno, Canhoto Carolina
General Surgery, Unidade Local de Saúde (ULS) de Viseu Dão-Lafões, Viseu, PRT.
Esophagogastric Surgery, Unidade Local de Saúde (ULS) de Viseu Dão-Lafões, Viseu, PRT.
Cureus. 2024 Dec 6;16(12):e75235. doi: 10.7759/cureus.75235. eCollection 2024 Dec.
Sclerosing mesenteritis is a chronic disease that primarily affects the mesenteric adipose tissue and encompasses a range of fibrotic and inflammatory pathologies. Due to its low incidence, the etiology remains unclear, though various factors are thought to contribute to its onset. Clinical manifestations are nonspecific, ranging from asymptomatic cases to persistent abdominal pain, which is the most common symptom. Incidental findings on imaging have increased with the widespread use of computed tomography (CT) scans. However, the diagnosis remains histological. Sclerosing mesenteritis is mainly associated with a good prognosis, as it typically follows a benign clinical course and rarely presents with complications or persistent symptoms. In this article, the authors present a clinical case of an 82-year-old male patient who presented with abdominal pain, constipation, and vomiting. The patient underwent an urgent laparotomy for intestinal occlusion. Histological examination confirmed sclerosing mesenteritis. Due to its limited understanding, sclerosing mesenteritis is often misdiagnosed. It should be considered as a differential diagnosis, particularly in patients with poorly defined abdominal pain, normal laboratory studies, and nonspecific imaging findings, to avoid unnecessary treatments. Nonetheless, urgent surgical intervention may be necessary in cases presenting with intestinal occlusion or uncontrolled pain.
硬化性肠系膜脂膜炎是一种主要影响肠系膜脂肪组织的慢性疾病,涵盖一系列纤维化和炎症性病变。由于其发病率较低,病因尚不清楚,不过多种因素被认为与其发病有关。临床表现不具有特异性,从无症状病例到持续性腹痛(最常见症状)不等。随着计算机断层扫描(CT)的广泛应用,影像学偶然发现的病例有所增加。然而,诊断仍需依靠组织学检查。硬化性肠系膜脂膜炎主要预后良好,因为它通常呈良性临床病程,很少出现并发症或持续性症状。在本文中,作者介绍了一例82岁男性患者的临床病例,该患者出现腹痛、便秘和呕吐症状。患者因肠梗阻接受了紧急剖腹手术。组织学检查确诊为硬化性肠系膜脂膜炎。由于对其认识有限,硬化性肠系膜脂膜炎常被误诊。应将其作为鉴别诊断考虑,尤其是对于腹痛不明确、实验室检查正常且影像学表现非特异性的患者,以避免不必要的治疗。尽管如此,对于出现肠梗阻或疼痛无法控制的病例,可能需要紧急手术干预。