Symptoms of mesenteric panniculitis can vary between individuals but often include inflammation and abdominal pain.
In this article, we look at the causes and symptoms of mesenteric panniculitis, as well as how the symptoms are managed.
What is mesenteric panniculitis?
The mesentery attaches the intestine to the abdominal wall.
Mesenteric panniculitis is a chronic disorder that affects fat cells in the mesentery. The mesentery is a fold of tissue in the abdomen that attaches the intestine to the abdominal wall to hold it in place.
Mesenteric panniculitis causes persistent inflammation, which can damage or destroy fat cells in the mesentery. This can lead to scar tissue and other symptoms.
There are three stages of mesenteric panniculitis. These are:
- Mesenteric lipodystrophy, which is when the fat cells start to be replaced by cells from the immune system.
- Mesenteric panniculitis, when more immune system cells enter the mesentery and cause inflammation.
- Retractile mesenteritis, when inflammation worsens, and scar tissue begins forming in the mesentery.
While mesenteric panniculitis is usually not life-threatening, symptoms can make daily life difficult. It may also be a sign of an underlying condition that could be more serious.
Causes and risk factors
There is currently no known direct cause for mesenteric panniculitis. It is typically treated as an autoimmune disease.
The immune system usually works to fight off invading germs that could harm the body. It surrounds these invaders, to cut them off from the rest of the body. This attack causes temporary inflammation until the germs have been eliminated.
In a person with an autoimmune disorder, the body mistakes regular cells for harmful ones and starts attacking itself. In mesenteric panniculitis, the body starts attacking the mesentery, causing inflammation, scar tissue, and other symptoms.
There may be a genetic link to mesenteric panniculitis. People with the disorder may also have a blood relative who has it or other autoimmune diseases.
Mesenteric panniculitis may be more common in people over 60 years of age, and more common in men than in women.
Additionally, inflammation of the abdomen that may be classified as mesenteric panniculitis can be triggered by other incidents or damage to the abdomen and mesentery, such as from infections, accidents, or surgeries.
Some types of cancer can also cause inflammation and scarring in the mesentery, including:
- prostate cancer
- kidney cancer
- colon cancer
- stomach cancer
- lung cancer
- carcinoid tumors
Other disorders may also be linked to mesenteric panniculitis. These include some that cause or influence inflammation and scar tissue in the body, such as:
- retroperitoneal fibrosis
- sclerosing cholangitis
- riedel thyroiditis
- orbital pseudotumors
Symptoms of mesenteric panniculitis may include vomiting, diarrhea, fever, and nausea.
The most common symptom of mesenteric panniculitis is abdominal pain. This happens when the inflammation in the mesentery becomes bad enough that the swelling puts pressure on the organs around the mesentery and intestines.
Other symptoms of mesenteric panniculitis include abdominal and digestive complications, such as:
- feeling full after eating very little
- loss of appetite
- weight loss
The symptoms of mesenteric panniculitis may vary from person to person. Some people with the disorder may not notice any symptoms, or they may only notice minor symptoms. Others may experience severe symptoms that require hospitalization.
Some people may also have a sensation of having a lump in their abdomen. Symptoms of mesenteric panniculitis may last for weeks or months before going away.
Mesenteric panniculitis is rare and shares symptoms with many other disorders, so it is easy to misdiagnose.
People with mesenteric panniculitis often complain of abdominal pain, which may prompt the doctor to order an imaging test, such as a computed tomography (CT) scan. CT scans can detect signs of thickness or scarring in the tissues of the abdomen.
If doctors notice scarring or inflammation in the mesentery, they may order a blood test to look for other indications of inflammation in the body.
Doctors may also order a biopsy to be certain of their diagnosis. During a biopsy, a small sample of mesentery tissue is taken from the body and sent to a lab for testing.
Once the diagnosis is confirmed, doctors may look for an underlying cause of the disorder and discuss treatment options.
Treating mesenteric panniculitis will focus on alleviating its symptoms. Many people do not need treatment for the disorder itself, and symptoms may go away on their own within a few weeks or months. Others may have severe symptoms that require hospital visits and medical intervention.
In cases where symptoms affect daily life, doctors may prescribe medications to treat the inflammation or other specific symptoms.
Corticosteroids are often used to help suppress an overactive immune system and reduce inflammation in the abdomen.
Additional medicines may be prescribed, depending on the symptoms and any related conditions. These may include anti-tumor drugs and drugs to suppress the immune system.
Complications and related conditions
The mesentery is a fold of tissue in the abdomen.
Mesenteric panniculitis is usually benign, meaning the condition itself is not dangerous or cancerous. However, complications can occur.
Severe inflammation can cause slowing and blockages in the intestines. This can make other symptoms worse, such as nausea and bloating. It may also be a contributing factor for abdominal pain.
In some cases, the added pressure from blockages in the intestines can make it more difficult for the body to absorb the nutrients from food.
Mesenteric panniculitis can also occur alongside some cancers. Doctors will rule out cancers during their diagnosis.
Mesenteric panniculitis is a long-lasting condition, but it is not life-threatening. The disorder usually improves without treatment, but some symptoms can disrupt daily life. Management of these symptoms is crucial to maintaining a person's quality of life.
Doctors will also check for any underlying conditions that could be causing mesenteric panniculitis. Working closely with a doctor to monitor the progress of the condition is the best way to avoid complications and relieve symptoms.