Nadir bir akut batın nedeni: Mezenterik pannikülit

Yıl 2022, , 64 - 66, 31.05.2022

Murat Kartal , Tolga Kalaycı

https://doi.org/10.55665/troiamedj.1060934

Öz

Mezenterik pannikülit primer olarak ince barsak mezenterini, nadir olarak da mezokolonu ve omentumu tutan akut veya subakut seyreden inflamatuvar bir hastalıktır. Bu olgu sunumunda, akut karın ağrısı nedeniyle kliniğimize başvuran ve laparotomide mezenterik pannikülit tanısı konulan hastamızın tanı ve tedavi sürecinin sunulması amaçlanmıştır. Altmış iki yaşında kadın hasta iki gün önce başlayan karın ağrısı, bulantı ve kusma nedeniyle başvurdu. Muayenede akut batın hali olan fakat görüntülemelerde ince barsak tipi ileus dışında patoloji olmayan hasta medikal tedavi için yatırıldı. Medikal tedaviye rağmen batın muayenesi rahatlamayan hastaya tanısal laparotomi yapıldı. Laparotomide ince barsaklarda ödem ve ince barsak mezenterinde barsak duvarına yakın alanda multipl inflamatuvar alanlar (pannikülit ile uyumlu) mevcuttu. Ameliyat sonrası serviste takip edilen ve takiplerinde sorun olmayan hasta postoperatif 3. günde taburcu edildi.

Anahtar Kelimeler

ileum, laparatomi, pannikülit

A rare cause of acute abdomen: Mesenteric panniculitis

Öz

Mesenteric panniculitis is an acute or subacute inflammatory disease that primarily involves the small intestine mesentery, rarely the mesocolon and omentum. In this case report, it is aimed to present the diagnosis and treatment process of our patient who applied to our clinic with acute abdominal pain and was diagnosed with mesenteric panniculitis at laparotomy. A 62-year-old female patient presented with abdominal pain, nausea and vomiting that started two days ago. The patient, who had acute abdomen on examination but had no pathology other than small bowel type ileus, was hospitalized for medical treatment. Diagnostic laparotomy was performed to the patient whose abdominal examination did not improve despite medical treatment. At laparotomy, there were edema in the small intestine and multiple inflammatory areas (consistent with panniculitis) in the small intestine mesentery close to the intestinal wall. The patient, who was followed in the service at postoperative period and had no problems in the follow-up, was discharged on the 3rd postoperative day.

Anahtar Kelimeler

ileum, laparotomy, panniculitis

Kaynakça

• 1. Coşkun BDÖ, Sevinç E, Kalan U, Altınkaya E, Tekiş D, Koç A. Nadir bir karın ağrısı nedeni: Mezenterik pan-nikülit. Akademik Gastroenteroloji Dergisi 2016;15(1):28-30.
• 2. Hussein MRA, Abdelwahed SR. Mesenteric panniculi-tis: An update. Expert Review of Gastroenterology & Hepatology 2015;9(1):67-78.
• 3. Van Lingen CP, Zeebregts CJ, Gerritsen JJ, Klaase JM, Van Baarlen J. Mesenteric panniculitis presenting as colitis. ANZ Journal of Surgery 2004;74(3):176.
• 4. Ekuke EO, Diallo FD, Benjelloun EB, Benajah D-A. Mesenteric panniculitis: Case report. Journal of Surgery and Medicine 2018;2(3):350-2.
• 5. van Breda Vriesman A, Schuttevaer H, Coerkamp E, Puylaert J. Mesenteric panniculitis: US and CT features. European Radiology 2004;14(12):2242-8.
• 6. Delgado Plasencia L, Rodríguez Ballester L, López-Tomassetti Fernández E, Hernández Morales A, Carrillo Pallarés A, Hernández Siverio N. Paniculitis mesentérica: Experiencia en nuestro centro. Revista Española de Enfermedades Digestivas 2007;99(5):291-7.
• 7. Gögebakan Ö, Osterhoff MA, Albrecht T. Mesenteric panniculitis (MP): A frequent coincidental CT finding of debatable clinical significance. Rofo 2018;190(11):1044-52.
• 8. Daskalogiannaki M, Voloudaki A, Prassopoulos P, et al. CT evaluation of mesenteric panniculitis: Prevalence and associated diseases. AJR Am J Roentgenol 2000;174(2):427-31.
• 9. Marsaudon E, Berthy J, Gautreault A, Mamoune S, Boucekkine R. Acute abdominal pain. Rev Med Interne 2018;39(10):827-8.
• 10. Castro YM, Ramón RD, Baró DL. Paniculitis mesen-térica. Revista Cubana de Medicina 2021;60(4).
• 11. Grieser C, Denecke T, Langrehr J, Hamm B, Hänninen EL. Sclerosing mesenteritis as a rare cause of upper ab-dominal pain and digestive disorders. Acta Radiol 2008;49(7):744-6.
• 12. Küpeli A, Göktepeli M. Mesenteric panniculitis. Arch Basic Clin Res 2019;1(1):41-2.
• 13. Buragina G, Biasina AM, Carrafiello G. Clinical and radiological features of mesenteric panniculitis: A criti-cal overview. Acta Bio Medica: Atenei Parmensis 2019;90(4):411.
• 14. Miyake H, Sano T, Kamiya J, et al. Successful steroid therapy for postoperative mesenteric panniculitis. Sur-gery 2003;133(1):118-9.
• 15. Rudraiah H, Kalke SV, Desai A. A rare case report of sclerosing mesenteritis presenting as a huge abdominal mass. Journal of Advanced Clinical and Research In-sights 2018;5(5):170-2.
• 16. Sağnak Z, Ersöz Ş, Mungan S, Alhan E. Tümör benzeri kitle oluşturan mezenterik pannikülit: Olgu sunumu. Fırat Tıp Dergisi 2017;22(1):55-58.
• 17. Başol N. Mesenteric panniculitis. Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi 2012; 4:1-7.