Viêm mạc treo xơ hóa

Viêm mạc treo xơ
hóa

Đỗ Hồng Trọng


case


Name of lesion
Sclerosing mesenteritis : Viêm mạc treo xơ hóa
Mesenteric panniculitis : inflammation over fibrosis
Retractile mesenteritis: : predominance of fibrosis and retraction
Misty mesentery �
Mesenteric lipodystrophy: Fat necrosis
Male/female:2,3/1
44.2% (n = 85) chronic while 35.4% (n = 68) presented acutely.

Sharma P, Yadav S, Needham CM, Feuerstadt P. Sclerosing mesenteritis: a systematic review of 192 cases. Clin J Gastroenterol. 2017;10(2):103-111. doi:10.1007/s12328-017-0716-5


Symtom and Laboratory parameter
-

Normal

-

Abdominal pain, fever, weight loss, anorexia and abdominal tenderness

-

Bowel obstruction or ischemia. Obstructive uropathy, renal failure
44.2% (n = 85) chronic while 35.4% (n = 68) presented acutely.
CRP and leukocystosis: elevated in 86.5% (n = 45) và (n = 33, 17.2%), respectively

Sharma P, Yadav S, Needham CM, Feuerstadt P. Sclerosing mesenteritis: a systematic review of 192 cases. Clin J Gastroenterol. 2017;10(2):103-111. doi:10.1007/s12328-017-0716-5


Treatment and complication
There were 41.7% (n = 80) surgically resected, 34.9% (n = 67) underwent medical treatment and 17.2% (n = 33) were
managed conservatively.
When additional medical therapy was given, steroids (n = 18, 46.1%), azathioprine (n = 8, 20.5%), colchicine (n = 5,
12.8%) and cyclophosphamide (n = 3,7.7%) were the most frequently used medications.
20.8% (n = 40) developed complications with the most common being bowel obstruction/ileus/ischemia (n =
10,23.8%),obstructive uropathy/renal failure(n = 10,23.8%), steroid related complications (n = 6, 14.3%),sepsis/respiratory
failure(n = 6,14.3%) andvenous thromboembolism (n = 4, 10.0%). Other complications which included pericardial
effusion (n = 2, 5.0%) and pulmonary edema (n = 1, 2.5%) were seen less frequently.

Sharma P, Yadav S, Needham CM, Feuerstadt P. Sclerosing mesenteritis: a systematic review of 192 cases. Clin J Gastroenterol. 2017;10(2):103-111. doi:10.1007/s12328-017-0716-5


etiology and mechanism of disease

•

theory of abnormal post-surgical healing and ischemia to the mesentery

Sharma P, Yadav S, Needham CM, Feuerstadt P. Sclerosing mesenteritis: a systematic review of 192 cases. Clin J Gastroenterol. 2017;10(2):103-111. doi:10.1007/s12328-017-0716-5

Imaging
Hyperattenuating fat (approximately -40 to -60 HU)
Fat-ring sign or Fatty halo
Tumoral pseudocapsule
Soft-tissue nodules


Differental diagnosis

Sclerosing mesenteritis

Metastasis of carcinoid tumor

Mesenteric stranding

+

76%

Calcification

20%

70%

Vessel displacement

40%

+

T2WI

low

Low to high


Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Trước tiêm

Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Sau tiêm và dựng coronal

Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8

Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Sinh thiết

Radiat Med. 2006;24(3):220-223. doi:10.1007/s11604-005-1405-8


Trích dẫn
Matsuki M, Inada Y, Nakai G, et al. CT and MR features of sclerosing mesenteritis mimicking a
mesenteric metastasis from the carcinoid tumor. Radiat Med. 2006;24(3):220-223.
doi:10.1007/s11604-005-1405-8

Sharma P, Yadav S, Needham CM, Feuerstadt P. Sclerosing mesenteritis: a systematic review of
192 cases. Clin J Gastroenterol. 2017;10(2):103-111. doi:10.1007/s12328-017-0716-5