Sclerosing Mesenteritis as a Rare Presentation with Abdominal Pain and Intraabdominal Mass: A Cases Report and Review of the Literature
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Abstract:
Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammatory disease with unknown etiology that affects the mesentery. On rare occasions, it may involve the mesocolon, peripancreatic region, omentum, retroperitoneum, or pelvis. Our patient 57-year-old male presented with chronic abdominal pain for about 6 months and intra-abdominal mass for about 2 months. The abdominal pain, mainly located around navel, was intermittent and mild. The mass, located in the right lower quadrant, was mobile, smooth, rigid and about the size of a fist. The laboratory profile of routine blood test, renal and hepatic function tests were normal. Abdominal CT scan demonstrated a solid soft-tissue mass with calcification in the right lower abdomen, which correlated with small bowel and mesentery. The patient was subjected to exploratory laparotomy because of radiologist apprehension of the mass being celiac teratoma, the intraoperative frozen section indicated that it was an inflammatory mass. The mass and adhered intestines were removed. The biopsy of pathological specimens with paraffin section showed fat necrosis, sclerosing fibrosis, clusters of inflammatory cells and lipid-laden macrophages in mesentery mass; and the inflammatory stopped abruptly at the edge of bowel wall So this case was diagnosed with sclerosing mesenteritis in the end. The patient recovered well after surgery without any digestive discomfort. No recurrence of the sclerosing mesenteritis was observed during follow-up.
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