Sclerosing mesenteritis is a rare disease that affects a fold of tissue that connects the small bowel to the wall of the abdomen. This fold is called the small bowel mesentery. Inflammation and scarring (fibrosis) of the small bowel mesentery are the main features of sclerosing mesenteritis. It occurs most often in persons in their sixties.
How rare is sclerosing mesenteritis?
Sclerosing mesenteritis is estimated to occur in about 0.6% of the population.
Are the causes of sclerosing mesenteritis known?
Finding the cause has been difficult, but it is thought that patients with sclerosing mesenteritis have had abdominal surgery or trauma to the abdomen. They also may have autoimmune diseases in which the body produces an inappropriate immune response to its own tissues and substances.
Some patients with sclerosing mesenteritis may have had cancer. Infection is another possible cause, as some patients with sclerosing mesenteritis have had typhoid fever, dysentery, malaria, and rheumatic fever, among others.
What are the symptoms of sclerosing mesenteritis?
Abdominal pain is the most common symptom. You may also experience:
A distended(swollen) abdomen
Nausea and vomiting
How is sclerosing mesenteritis diagnosed?
Your doctor may feel your abdomen for a mass or any signs of tenderness. If either is present, a computed tomography (CT) scan of your abdomen may be ordered. A CT scan will normally show a soft-tissue mass as a sign of sclerosing mesenteritis.
How is sclerosing mesenteritis treated?
Your doctor may prescribe medications to relieve symptoms, but if the sclerosing mesenteritis leads to a bowel blockage, you will need surgery. The medications your doctor may prescribe are glucocorticoid drugs such as prednisone, which relieve inflammation. They may be used in combination with azathioprine and colchicine.
Hormonal therapy such as tamoxifen has also been shown to work. Sometimes hormonal therapy is used together with glucocorticoid drugs. Cyclophosphamide and thalidomide have also been used, although their success is not well proven.
The medications may take several weeks to work. You may need to take the medication on an ongoing basis because stopping treatment may lead to return of the disease.
Akram S, Pardi DS, Schaffner JA, Smyrk TC. Sclerosing mesenteritis: Clinical features, treatment, and outcome in ninety-two patients. Clin Gastroenterol Hepatol 2007;5:589-596.
Bala A, Coderre SP, Johnson DR, Nayak V. Treatment of sclerosing mesenteritis with corticosteroids and azathioprine. Can J Gastroenterol 2001;15:533.
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