S状結腸間膜に限局した極めて稀なる脂肪組織炎（Mesenteric Panniculitis―Ogden）の1例

A Very Rare Case of Chronic Panniculitis Localized at the Mesentery of the Sigmoid Colon

　腸間膜脂肪組織炎（mesenteric panniculitis）は腸間膜の非特異性慢性炎症性疾患で非常に珍しい疾患である．しかも本症は小腸の腸間膜に発生することが多く，結腸間膜に生じた報告例は少ない．最近著者らはS状結腸間膜に限局した極めて稀な脂肪組織炎の1例を経験したので報告する．

　A 72 year-old man, who had neither previous abdominal surgery nor traumas, was admitted on March 4, 1977. He had had a month's history of abdominal pain and diarrhea which lasted for 2 weeks prior to his admission. Physical examination revealed a tender and firm palpable mass in the right paraumbilical region.

　The laboratory findings on admission were as follows: hemoglobin 14.6g%, RBC 419×10⁴WBC 6500 with 75% neutrophils and 15% lymphocytes, erythrocyte sedimentation rate of 39 mm (1-hour-value), positive CRP, diabetic glucose tolerance test (100g oral).

　Barium enema study demonstrated the sigmoid lesion with shortening deviation to the right and narrowing with irregular contours. Sigmoidscopic examination showed redness and edema of the regional sigmoidal mucosa.

　On April 19, sigmoid colectomy combined with the regional resection of mesentery was performed. Operation findings were as follows: The sigmoid was shortened and the mesentery involved showed thickness and induration with many firm nodules in various size. Microscopic examination revealed degenerated fat cells, focal aggregate of lipophages, perivascular collections of lymphocytes, and plasma cells and fibrosis.

　The final pathological diagnosis was chronic panniculitis of the mesentery. In particular, panniculitis limited only to the mesentery of the large bowel is very rare and this seems to be the first case report made in Japan.