Sclerosing mesenteritis It is a rare inflammatory disease of the mesentery charactarized by
sclerosing fibrosis, fat necrosis and lipid laden macrophages.
It commonly
affect males in their fifth decade, the inflammatory process usually involve the
mesentery of small bowel at the base, but never invade the bowel itself, it may cause
bowel obstruction or impede venous and lympathic drainage from the bowel due to retraction of fibrotic strands surrounding these vessels.
Clinically in more than 50% of patients a
mass is palpable, on CT scans a fatty mass with well marked borders seperating it from normal mesentery is seen,
fat ring sign is also charactaristic which is caused by enhanced fat surrounding blood vessels (see fig above), Laboratory investigations may show high ESR and CRP.
Definitive diagnosis requires biopsy to differentiate this condition from peritoneal carcinomatosis and other inflammatory conditions of the peritoneum.
