Mesenteric panniculitisの1例

Mesenteric Panniculitis, Report of a Case

　腸間膜脂肪織に選択的に発生する腸間膜脂肪織炎 mesenteric panniculitis はまれな疾患で，病因，診断法，治療法ともいまだ確立されていない．最近著者らは，下行結腸に沿う後腹膜脂肪織とS状結腸間膜にみられた本症の1例を経験したので報告する．

　A case of mesenteric panniculitis seen in a 61-year-old man is reported. The patient presented with diarrhea, left lower abdominal pain, and mild fever of three weeks' duration.

　Physical examination revealed a tender and firm palpable mass in the left iliac region.Body temperature was 38.0℃. Barium enema study demonstrated thickening, narrowing, and irregular contour at the mesenteric side in the sigmoid and the descending colon. Selective angiography of the inferior mesenteric artery revealed narrowing and irregularity of the marginal artery and vasa recta.

　At laparotomy, the sigmoid and the descending colon were edematous. Their mesenlerium as well as left retroperitoneal fatty tissue was diffusely thickened with nodal irregular surface. All other abdominal viscelae were normal. Histopathological diagnosis was chronic mesenteric panniculitis. A transverse colostomy was made.

　The patient was treated with 15mg of Predonisolone daily for 30 days because of continuous mild fever. Barium enema study carried out 80 days after the operation showed marked improvement of the lesion.

　The patient died of cerebral apoplexy eight months after the operation. Postmortem examination disclosed that the lesion of the mesenterium and the retroperitoneal fatty tissue disappeared completely.