• Abdominal Pain
• Computed Tomography
• Mesenteric Panniculitis
• Mesentery
• Sclerosing Mesenteritis
• Small Bowel

• asymptomatic
• benign course
• long-term observation
• mesenteric mass
• sclerosing mesenteritis

• Eclectus roratus
• avian
• disseminated coelomic xanthogranulomatous
• eclectus
• psittacine

• Male
• Animals
• Bird Diseases/diagnosis
• Bird Diseases/drug therapy
• Bird Diseases/pathology
• Inflammation/veterinary
• Parrots
• Granuloma/diagnosis
• Granuloma/drug therapy
• Granuloma/veterinary
• Xanthomatosis/veterinary
• Prednisolone/therapeutic use
• Bile Acids and Salts
• Minerals

• Acute abdomen
• Computed tomography
• Emergency radiology
• Epiploic appendagitis
• Ultrasound

• Humans
• Panniculitis, Peritoneal/pathology
• Abdominal Pain/diagnosis
• Abdominal Pain/etiology
• Neoplasms
• Tomography, X-Ray Computed/methods
• Abdomen, Acute/etiology

• Rheumatology
• Thyroid disease
• Thyroiditis

• Female
• Humans
• Thyroiditis/complications
• Thyroiditis/diagnosis
• Thyroiditis/pathology
• Goiter/complications
• Fibrosis

• chatgpt
• mesenteric lipodystrophy
• mesenteric panniculitis
• mesenteric scleritis
• retractile mesenteritis
• sclerosing mesenteritis

• PET
• follicular lymphoma
• response assessment

• Abdominal pain
• Computed tomography
• Medical therapy
• Mesenteric panniculitis

• Computed tomography
• Mesenteric panniculitis
• Neoplasms
• Panniculitis
• Peritoneal

To briefly discuss the imaging features of different types of intra-abdominal fat necrosis.

Trauma and ischemic insult may result in intra-abdominal fat necrosis. Fat necrosis may present with acute abdomen, clinically simulating with other etiologies, such as acute diverticulitis and acute appendicitis.

Imaging plays a crucial role in making the exact diagnosis and differentiating it from other pathologies that may require surgical intervention. Computed tomography (CT) is the most commonly used imaging modality. A small fat attenuation lesion with a hyperattenuating rim in contact with the ventral surface of the sigmoid colon indicates epiploic appendagitis while a larger fat-attenuation lesion on the right side of the abdomen in between the colon and anterior abdominal wall indicates omental infarction. Fat stranding at the root of the mesentery with fat ring sign represents inflammatory mesenteric panniculitis while retractile or sclerosing mesenteritis appears as a fibrotic spiculated mass with or without calcification, mimicking mesenteric carcinoid. In patients with acute pancreatitis, the amount of inflamed fat correlates with clinical severity and outcome.

Familiarity with the imaging features of different types of intraabdominal fat necrosis helps in establishing an accurate diagnosis, thus avoiding unnecessary intervention.

Patel RK, Mittal S, Singh S. Imaging of Mischievous Intra-abdominal Fat Presenting with Abdominal Pain: A Pictorial Review. Euroasian J Hepato-Gastroenterol 2022;12(1):45–49.

• adipose tissue
• autoimmune disease
• computerized tomography
• laparoscopy
• lymphatics
• lymphoma
• mesenteric fibrosis
• mesenteric lipodystrophy
• mesenteric panniculitis
• neoplasms
• paraneoplastic conditions
• positron emission tomography
• retractile mesenteritis
• sclerosing mesenteritis

• Abdominal Pain
• Female
• Humans
• Male
• Mesentery/diagnostic imaging
• Mesentery/pathology
• Panniculitis, Peritoneal/diagnostic imaging
• Panniculitis, Peritoneal/epidemiology
• Retrospective Studies
• Tomography, X-Ray Computed/methods
• Ultrasonography

Purpose: To evaluate the diagnostic performance of ultrasound point shear wave elastography (pSWE) using acoustic radiation force impulse (ARFI) technology in different benign and malignant mesenteric masses (MMs). Methods: A total of 69 patients with MMs diagnosed from September 2018 to November 2021 were included retrospectively in the study. The inclusion criteria were (1) an MM over 1 cm; (2) valid ARFI measurements; and (3) confirmation of the diagnosis of an MM by histological examination and/or clinical and radiological follow-up. To examine the mean ARFI velocities (MAVs) for potential cut-off values between benign and malignant MMs, a receiver operating characteristics analysis was implemented. Results: In total, 37/69 of the MMs were benign (53.6%) and 32/69 malignant (46.4%). Benign MMs demonstrated significantly lower MAVs than mMMs (1.59 ± 0.93 vs. 2.76 ± 1.01 m/s; p < 0.001). Selecting 2.05 m/s as a cut-off value yielded a sensitivity and specificity of 75.0% and 70.3%, respectively, in diagnosing malignant MMs (area under the curve = 0.802, 95% confidence interval 0.699–0.904). Conclusion: ARFI elastography may represent an additional non-invasive tool for differentiating benign from malignant MMs. However, to validate the results of this study, further prospective randomized studies are required.

• ARFI elastography
• mesenteric mass
• mesentery
• sclerosing mesenteritis
• ultrasound

Sclerosing mesenteritis (SM), a benign chronic fibrosing inflammatory disease of the mesentery, is a rare disease discovered in 1924. The prevalence of the disease is less than 1%. The exact etiology of the disease is not clear. It is thought that the integrity of the gastrointestinal lumen may be altered from chronic inflammatory effects. SM may be associated with autoimmune diseases, trauma, malignancy, or surgery. The most common clinical presentation is abdominal pain. Obstructive symptoms may occur. Diagnosis is made by CT abdomen and biopsy. Treatment includes surgical and immunosuppressive medications.

• colon perforation
• complicated sclerosing mesenteritis
• mesenteritis
• refractory sclerosing mesenteritis
• sclerosing mesenteritis

Sclerosing mesenteritis (SM) is a rare fibroinflammatory disorder that involves mesenteric adipose tissue, more frequently localized in the small intestine, with an insidious clinical presentation having symptoms related to mass effect, usually resulting in bowel obstruction, mesenteric ischemia, as well as rapid weight loss. We report a case of a 23-year-old male presenting with palpable abdominal mass, mesogastric pain, and a history of rapid weight loss, who underwent exploratory laparoscopy. A hemorrhagic and gelatinous nodular tumor mass of the mesentery was identified and the surgical procedure was converted to a laparotomic approach. Histologically, the mass was composed of a proliferation of bland-looking spindle cells with slightly eosinophilic cytoplasm and elongated normochromatic nuclei with mild nuclear atypia, haphazardly set in a collagenized stroma; fat necrosis and inflammatory cells (lymphocytes, plasma-cells, and histiocytes) were also evident. The diagnosis of sclerosing mesenteritis was made. Our case emphasizes that histology remains pre-eminent for a correct diagnosis of SM, as pre-operative radiological-based diagnosis is non-specific.

• abdominal mass
• fibroinflammatory disease
• mesenteric mass
• sclerosing mesenteritis
• small bowel obstruction

• Intestinal obstruction
• Lymphadenopathy, abdominal
• Mesentery
• Sclerosing mesenteritis
• Tamoxifen

• Abdominal Pain
• Aged
• Humans
• Male
• Mesentery
• Panniculitis, Peritoneal
• Ultrasonography
• Weight Loss

• Computed tomography
• Mesenteric panniculitis
• Metabolic syndrome
• Urolithiasis

• Acro-osteolysis
• Claw hands
• Mixed connective tissue disease
• Progressive systemic sclerosis
• Puffy fingers

• fat necrosis
• mesenteric mass
• sclerosing mesenteritis

• Early recurrence
• FDG PET/CT
• Malignant lymphoma
• Mesenteric panniculitis

• CT
• avian
• dystrophic mineralization
• radiographs
• ultrasound
• xanthogranulomatosis
• xanthoma

• anastomotic leakage
• anterior resection
• mesorectum CT value

Intra-abdominal fat is abundantly present in both the peritoneum and retroperitoneum. Fat necrosis or inflammation are common findings in abdominal imaging. The most common pathologies that we encounter are epiploic appendagitis, omental infarction, mesenteric panniculitis, and encapsulated fat necrosis. Less common entities that can occur are pancreatic saponification, heterotopic mesenteric ossification, and pseudolipoma of the capsule of Glisson. These entities can mimic more urgent pathologies such as appendicitis, diverticulitis, or malignancies.

• abdominal imaging
• computed tomography
• inflammation
• necrosis

•

Mesenteric lipodystrophy is a rare fibroinflammatory disease of unknown origin.

Mesenteric lipodystrophy is a rare fibroinflammatory disease of unknown origin with clinical and radiological non specific findings.

The case of a 42-years-old man affected by a pedunculated mesenteric lipodystrophy mimicking Meckel’s diverticulum is reported. Clinical, imaging and histological findings are discussed.

Mesenteric lipodystrophy affects the mesenteric fat of the abdomen with a typical diffuse thickening of the mesentery, nodular thickening of the mesenteric root and presence of mass-like lesions. Ultrasound (US) and Multiphasic Computed Tomography (CT) represent the main imaging tools used for diagnosis. Clinical and imaging findings can mimick other pathological conditions affecting the mesenteric fat tissue. Contrast enhanced CT is the most accurate imaging technique for diagnosing mesenteric lipodystrophy due to the high panoramicity and accuracy with multiplanar imaging. Multiphasic technique helps to characterize the lesion and to recognize vascular anatomy. Oral administration of iodinated contrast medium may help to assess the relationship with bowel loops. All these diagnostic elements are crucial for the surgical timing and approach.

Due to the heterogeneous mesenteric involvement, the nonspecific CT findings and the high number of diseases for differential diagnosis, the detection of mesenteric lipodystrophy is challenging and requires early clinical suspicion. An histological examination is always necessary.

The mesenteric panniculitis is a rare form of inflammation that mainly involves the mesenteric adipose tissue. The etiology remains unknown and the disease has been associated with various conditions such as cancer, abdominal trauma, previous surgery, autoimmune diseases and obesity. Mesenteric panniculitis can be divided into two main groups: the mesenteric panniculitis with only the inflammation and degeneration of the mesenteric fat, and the retractile panniculitis, mainly fibrotic, with retraction of the surrounding structures. From a radiological point of view, there are two main signs: the fat ring sign, which is the presence of normal fat around vessels and lymph nodes, and the pseudocapsula around the lesion. In this paper, we present the imaging and clinical features of mesenteric panniculits with particular reference to the differential diagnosis and the possible etiological associations. (www.actabiomedica.it)

Mesenteric panniculitis (MP) is a relatively rare pathology characterized by idiopathic local chronic inflammation of adipose tissue, mainly affecting the mesentery of the small intestine. The purpose of the study is to describe a case of MP. A 60-year-old patient visited a rheumatologist due to the progressive deterioration of his condition for the last 4 months and revealed changes on the computed tomography of the abdominal cavity. Treatment protocol: methylprednisolone 8 mg/day, pantoprazole 40 mg/day; continue with antihypertensive drugs. On the background of treatment after 2 months, the temperature became normal, appetite improved, and weakness decreased, with no relapses of abdominal symptoms. Diagnosis of MP is a difficult task, which has to be solved by primary care specialists. This clinical case is an example of MP diagnosis and positive dynamics of the patient’s clinical condition during therapy.

• computed tomography
• mesenteric panniculitis
• rheumatic diseases

• Carcinoid
• Desmoid
• Gastro-intestinal stromal tumors
• Lymphangioma
• Mesenteric panniculitis
• Mesentery
• Multidetector computed tomography

• Fibrosis
• Inflammation
• Mesenteric disease
• Retractile mesenteritis
• Sclerosing mesenteritis

• abdominal pain
• mesenteric panniculitis
• sclerosing mesenteritis

• 3D CT
• Carcinoid
• Cinematic rendering
• Gastrointestinal stromal tumor

• Sclerosing mesenteritis
• mesenteric lipodystrophy
• mesenteric panniculitis
• retractile mesenteritis

The process of abnormal reparative or reactive processes in the abdominal cavity, can lead to sclerosis and fibrous deposition. The relatively recent discovery of an IgG4 subgroup of immune mediated sclerosing disease 1,2 has thrown some light on the pathophysiology of these conditions. Firstly, our pictorial review aims to describe imaging findings to enhance the general radiologist's recognition and interpretation of this varied group of benign sclerotic and fibrotic abdominal processes. Secondly, along with the imaging findings, we bring into discussion the potential mimics of these pathologic processes to minimise interpretational errors. Moreover, some of the mimics of these processes are in the spectrum of malignant disease. Most importantly, to ensure a correct diagnosis thorough clinical and histopathological assessment are required to support the imaging findings presented in this review.

• Double-balloon enteroscopy
• Protein-losing enteropathy
• Sclerosing mesenteritis

• abdominal pain
• chylous ascites
• intestinal obstruction
• intestinal perforation
• panniculitis, peritoneal

• Abdominal Pain/etiology
• Aged, 80 and over
• Chylous Ascites/etiology
• Fatal Outcome
• Humans
• Intestinal Perforation/etiology
• Intestine, Small/injuries
• Male
• Panniculitis, Peritoneal/complications
• Panniculitis, Peritoneal/diagnostic imaging

• Antibiotics
• Idiopathic mesenteric panniculitis
• Nonsteroidal anti-inflammatory drugs
• Treatment

• Adult
• Aged
• Anti-Bacterial Agents/therapeutic use
• Anti-Inflammatory Agents/therapeutic use
• Diagnosis, Differential
• Female
• Humans
• Male
• Middle Aged
• Panniculitis, Peritoneal/diagnosis
• Panniculitis, Peritoneal/drug therapy
• Panniculitis, Peritoneal/epidemiology
• Panniculitis, Peritoneal/physiopathology
• Prevalence
• Retrospective Studies
• Tomography, X-Ray Computed

• Mesenteric panniculitis (MP)
• abdomen
• computed tomography (CT)
• mesentery
• neoplasm

• Antineoplastic agents
• Drug-induced complications
• Gastrointestinal toxicity
• Gastrointestinal tract
• Molecular targeted therapy

• Antineoplastic Agents/adverse effects
• Humans
• Intestinal Diseases/chemically induced
• Intestinal Diseases/diagnostic imaging
• Mesentery/diagnostic imaging
• Mesentery/drug effects
• Molecular Targeted Therapy/adverse effects
• Neoplasms/drug therapy
• Risk Factors