肠系膜脂膜炎(MP)是一种良性疾病,其特征是主要是小肠系膜的脂肪组织的慢性炎症和纤维化。MP通常在腹部的横断面成像上偶然发现,并且在将近一半的患者中可以无症状。据报道,最常见的临床症状是腹痛,其次是腹胀/扩张,腹泻,便秘,呕吐,厌食症,减肥,发烧,萎靡不振,和恶心。在计算机断层扫描中,MP被视为小肠系膜内脂肪衰减增加的团块样区域,通常位于腹部的左上腹。该块状区域包裹肠系膜血管并移位相邻的肠段。淋巴结常见于肠系膜异常区域。MP最常见的鉴别诊断之一是淋巴瘤,和正电子发射断层扫描/计算机断层扫描,如果怀疑并发潜在的恶性肿瘤,可以进行。由于MP的良性性质,治疗决策应以症状的严重程度和并发症的存在为指导.一线药物治疗是泼尼松和他莫昔芬。手术保留用于复发性肠梗阻的病例。本文提供了MP的评论,包括它的流行病学,病理生理学,临床表现,影像学发现,和治疗。
Mesenteric panniculitis (MP) is a benign condition characterized by chronic inflammation and fibrosis of adipose tissue mainly of the small bowel
mesentery. MP is commonly detected incidentally on cross-sectional imaging of the abdomen and can be asymptomatic in up to nearly half of patients. The most frequent clinical symptom reported is abdominal pain, followed by bloating/distention, diarrhea, constipation, vomiting, anorexia, weight loss, fever, malaise, and nausea. On computed tomography, MP is seen as a mass-like area of increased fat attenuation within the small bowel
mesentery, usually located in the left upper quadrant of the abdomen. This mass-like area envelops mesenteric vessels and displaces adjacent bowel segments. Lymph nodes are frequently seen within the area of mesenteric abnormality. One of the most common differential diagnoses of MP is lymphoma, and positron emission tomography/computed tomography may be performed if there is suspicion of a concurrent underlying malignancy. Because of the benign nature of MP, treatment decisions should be guided by severity of symptoms and presence of complications. First-line medical treatment is prednisone and tamoxifen. Surgery is reserved for cases of recurrent bowel obstruction. This article provides a
review of MP, including its epidemiology, pathophysiology, clinical presentation, imaging findings, and treatment.