Sclerosing Mesenteritis

Overview

What is sclerosing mesenteritis?

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. The condition is also known as mesenteric panniculitis.

How rare is sclerosing mesenteritis?

Sclerosing mesenteritis is estimated to occur in about 0.6% of the population.

Symptoms and Causes

What causes sclerosing mesenteritis?

The actual cause of sclerosing mesenteritis hasn't yet been found. However, there are some factors that are thought to increase the risk. If you've had surgery or other types of trauma to the abdomen, you may be at greater risk. Another factor may be having an autoimmune disease. In these conditions, your body produces an inappropriate immune response to its own tissues and substances and attacks the tissue.

Some people with sclerosing mesenteritis may have or have recovered from cancer. Infection is another possible cause, as some people with sclerosing mesenteritis have had typhoid fever, dysentery, malaria, and rheumatic fever, among other diseases.

What are the symptoms of sclerosing mesenteritis?

Abdominal pain is the most common symptom. You may also experience:

  • Diarrhea.
  • Bloating.
  • A distended (swollen) abdomen.
  • Nausea and vomiting.
  • Weight loss.
  • Fever.

Diagnosis and Tests

How is sclerosing mesenteritis diagnosed?

Your healthcare provider 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.

Management and Treatment

How is sclerosing mesenteritis treated?

Your provider may prescribe medications to relieve symptoms, but if the sclerosing mesenteritis leads to a bowel blockage, you will need surgery. You may get prescriptions for 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 isn’t 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.

Outlook / Prognosis

What is the prognosis if you have sclerosing mesenteritis?

The outlook for people with sclerosing mesenteritis is good. Treatments for the condition are effective.

Last reviewed by a Cleveland Clinic medical professional on 10/26/2020.

References

  • 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.
  • Genetic and Rare Diseases Information Center. Sclerosing Mesenteritis. (https://rarediseases.info.nih.gov/diseases/8169/sclerosing-mesenteritis) Accessed 10/26/2020.
  • National Organization for Rare Disorders. Mesenteric Panniculitis. (https://rarediseases.org/rare-diseases/mesenteric-panniculitis/) Accessed 10/26/2020.

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