Mesenteric panniculitis is a non-neoplastic disorder characterized by a tumour-like expansion of the mesentery due to an inflammatory/fibrosing process in the fatty tissue. Although associated with many other conditions, including recent surgery and especially lymphomas, its cause is really unknown. It’s 2-3 times more common in men than in women, though rare overall (I’ve seen only 2 cases in many years of practice).

Acute and chronic abdominal pain can occur, as can intestinal obstruction, nausea, malaise, low fever and weight loss. Mesenteric panniculitis often follows a slow benign course, and once the mass resolves, it rarely recurs. A minority of patients, however, progress to chronic symptoms of pain or bowel obstruction. Nearly half of cases never develop any symptoms.

The diagnosis may be difficult to make until a CT scan is done. Lab tests are usually normal, though ESR may sometimes be elevated. Subsequently biopsy can confirm the diagnosis. Treatment modalities include: antiinflammatories, steroids, immunosuppressives and — rarely — surgery.

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