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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sclerosing mesenteritis is a chronic and extremely rare inflammatory process that predominantly affects the small bowel mesentery. However, the peripancreatic region, the omentum and the retroperitoneum can also be involved. The etiology and pathogenesis of the disease are as yet unknown, but autoimmune disorders, previous abdominal surgery, trauma, ischemia and drugs could play a role. The clinical picture is nonspecific and varies from asymptomatic to diffuse abdominal complaints. Radiologic work-up and histologic evaluation of a biopsy specimen usually do not reveal typical findings and therefore establishment of the correct diagnosis is challenging. Owing to the rarity of the disease, there is no consensus on optimal pharmaceutical treatment and most patients are treated empirically. Surgical therapy is limited to biopsies for histologic confirmation of the tumor and management of complications. We report a case of a 51-year-old man with a large retroperitoneal mass. Magnetic resonance angiography showed a 9.7 x 7.7 x 5.9 cm tumor above the aortic bifurcation with encasement of the aorta and the vena cava. CT-guided biopsy was inconclusive but surgical biopsy provided a histologic diagnosis of sclerosing mesenteritis. The operative and postoperative course was uneventful and therapy with prednisolone and azathioprine was started. At 6 months' follow-up, the patient was in good condition and asymptomatic. Sclerosing mesenteritis, though a rare entity, should be included in the differential diagnosis when a patient presents with a mesenterial or retroperitoneal tumor.
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PMID:Sclerosing mesenteritis, a rare cause of a retroperitoneal tumor. 2036 82

Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery. It produces tumor-like masses of the mesentery composed of varying degrees of fibrosis, chronic inflammation, and fat necrosis. It has been described variously as fibrosing mesenteritis, retractile mesenteritis, mesenteric Weber Christian disease, and systemic nodular panniculitis. The etiology and pathogenesis of the disease are as yet unknown, but autoimmune disorder, previous abdominal surgery, trauma, and ischemia could play a role. The clinical features include abdominal pain, vomiting, diarrhea, and constipation. Occasionally, patients with this condition may present with bowel obstruction. Rarely, It can be associated with other idiopathic inflammatory disorders such as retroperitoneal fibrosis, sclerosing cholangitis, and orbital pseudotumors. We report a case of idiopathic sclerosing mesenteritis with retroperitoneal fibrosis in a 58-year-old man.
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PMID:[A case of idiopathic sclerosing mesenteritis with retroperitoneal fibrosis]. 2204 24

Sclerosing mesenteritis is a rare benign disease originated from the mesenteries. It can be related to autoimmune disease, vasculitis, ischemia, infection, trauma and operation, but most of cases are idiopathic. The overall prognosis of sclerosing mesenteritis is usually good with benign, course. However, no consensus of treatment has yet been established. We report a case of spontaneous partial regression of sclerosing mesenteritis presented as a huge mass and diagnosed by finding of contrast enhanced abdominal computed tomography and percutaneous ultrasonography guided needle biopsy.
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PMID:[Spontaneous regression of sclerosing mesenteritis presenting as a huge mass]. 2254 31

Sclerosing mesenteritis falls within a spectrum of primary idiopathic inflammatory and fibrotic processes that affect the mesentery. The exact etiology has not been determined, although the following associations have been noted: abdominal surgery, trauma, autoimmunity, paraneoplastic syndrome, ischemia and infection. Progression of sclerosing mesentritis can lead to bowel obstruction, a rare complication of this uncommon condition. We report a case of a 66-year-old female with abdominal pain who was noted to have a small bowel obstruction requiring laparotomy and a partial small bowel resection. The pathology of the resected tissue was consistent with sclerosing mesenteritis, a rare cause of a small bowel obstruction. Sclerosing mesenteritis has variable rates of progression, and there is no consensus regarding the optimal treatment. Physicians should consider sclerosing mesenteritis in the differential diagnosis of a small bowel obstruction.
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PMID:Sclerosing Mesenteritis: A Rare Cause of Small Bowel Obstruction. 2740 4

BACKGROUND Sclerosing mesenteritis (SM) is a rare idiopathic inflammation and fibrosis of the mesentery. Its etiology and pathogenesis remain unclear. It has been linked to abdominal trauma related to peritoneal dialysis, recent abdominal surgery, idiopathic inflammatory disorder, paraneoplastic syndrome, ischemia/infection, and autoimmunity. Abdominal CT is the most sensitive imaging modality, and diagnosis is usually confirmed by surgical biopsy. Patients most often present with abdominal pain, nausea, vomiting, diarrhea, and weight loss, and less commonly with chylous ascites and small bowel obstruction. Treatment is usually supportive; surgical intervention may be attempted for life-threatening complications such as bowel obstruction or perforation. CASE REPORT This report describes an 80-year-old man with hypertension and end-stage renal disease (ESRD) presenting with increasing abdominal pain and tenderness over the past 5 months. Abdominal enhanced computed tomography (CT) revealed a fat-ring sign and peritoneal calcifications along the serosa surface of small bowel consistent with sclerosing mesenteritis. His hospital course was complicated by increasing ascites requiring multiple ultrasound-guided paracentesis, worsening leukocytosis, and persistent hypotension after dialysis, requiring pressor support. Ascitic fluid analysis was consistent with chylous ascites. The patient subsequently developed small bowel obstruction causing focal perforation, leading to the death of our patient. In this report, we review the clinical presentation, radiographic findings, treatment, and outcome in our patient and review the relevant literature. CONCLUSIONS Diagnosis of sclerosing mesenteritis is challenging due to its nonspecific clinical features. Sclerosing mesenteritis is a debilitating albeit self-limiting disorder that can rarely become fulminant, largely due to its complications.
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PMID:Sclerosing Mesenteritis Causing Chylous Ascites and Small Bowel Perforation. 2863 5

Sclerosing mesenteritis is a rare non-neoplastic disorder characterized by fat necrosis, chronic inflammation, and fibrosis typically of the small bowel mesentery. Our understanding of this disorder is limited by its rarity as well as inconsistent terminology used across the literature. While prior abdominal surgery or trauma, autoimmunity, infection, ischemia, and malignancy have been suggested to be involved in the pathogenesis of the disorder, it remains poorly understood. The clinical course of sclerosing mesenteritis is generally benign with a large proportion of patients diagnosed incidentally on imaging obtained for other indications. In a subset of patients, symptoms may arise from a mass effect on the bowel, lymphatics, or vasculature resulting in bowel obstruction, chylous ascites, or mesenteric ischemia. Symptomatic patients should be treated with a combination of corticosteroid and tamoxifen as first-line therapy based on retrospective case series and experience in other fibrosing disorders. Surgical intervention may be required in those with persistent obstruction despite conservative treatment, though complete resection of the mass is often not feasible given intimate involvement with the mesenteric vasculature. A careful use of terminology and communication between the radiologist, pathologist, and clinicians in the care of these patients will be essential to future efforts at understanding this disease.
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PMID:Sclerosing Mesenteritis. 3082 77

BACKGROUND Sclerosing mesenteritis is an inflammatory and fibrotic disease that affects the mesentery of the small intestine. This condition is non-neoplastic, although it is frequently associated with underlying malignancies. The overall etiology is unclear because of the limited number of cases available for review, yet a number of possible mechanisms have been described, including ischemia. Factor V (FV) Leiden is a hereditary condition causing hypercoagulability, thrombosis, and ischemia. Because ischemia is one of the proposed mechanisms for the fibrosis and sclerotic findings of sclerosing mesenteritis, this case explores a possible association between FV Leiden and sclerosing mesenteritis. CASE REPORT Herein, we describe a case of sclerosing mesenteritis in a patient heterozygous for FV Leiden, with a strong personal and family history of venous thromboembolism. This patient presented with acute worsening of chronic abdominal pain and was found to have a small bowel obstruction requiring acute surgical intervention. Imaging findings and pathologic examination of the ileum and mesentery conclusively diagnosed sclerosing mesenteritis. CONCLUSIONS This case serves to highlight a possible association between mesenteric ischemia secondary to chronic thrombotic activity and sclerosing mesenteritis. This patient's virgin abdomen and lack of additional risk factors for sclerosing mesenteritis make this case a unique presentation of the disorder. This case serves to update the literature at large, as only one prior case in a FV Leiden patient has been described, in which the patient had the additional risk factor of previous abdominal surgery.
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PMID:Sclerosing Mesenteritis in a Patient Heterozygous for Factor V Leiden. 3301 82