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A Journal on Internal Medicine and Pharmacology

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 February;164(1):55-7

language: English

A case of mesenteric panniculitis: multiple involvement of the Emergency Room before definitive diagnosis and appropriate treatment

Volpicelli G. 1, Saracco W. 2, Pinna G. 2

1 Department of Emergency Medicine, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy;
2 Department of Internal Medicine, General Hospital, Asti, Italy


The appropriate diagnosis and care of abdominal pain in the primary care setting is often a challenge for the doctor in the emergency room. There is a wide variety of disease which could present with abdominal symptoms owing the patient to repeatidly recurring at the primary care service in the Hospital. Among them, there is a rarely encountered inflammatory condition of the mesentery, which may lead to recurrent acute abdominal pain: mesenteric panniculitis. Knowledge of this rare syndrome should prevent any unwarranted aggressive surgical therapy and help to use the clinical, radiological and surgical sources to obtain the right diagnosis. We describe a case of mesenteric panniculitis, which presented at our emergency room with symptoms of acute abdominal pain, fever and prolonged partial thromboplastin time (aPTT). The patient had a history of recurrent emergency department access, complaining of the same clinical picture, rapidly reversible. Finally, abdomen computed tomography scan findings and diagnostic laparascopy with histology were performed, and it was decisive to reach correct diagnosis and treatment. Mesenteric panniculitis is a rare disease, the recognition of which is important in order to avoid any unwarranted surgical aggressive treatment. A brief report of what is known from literature analysis about diagnosis and therapy of mesenteric panniculitis is reported. Finally we briefly discuss some peculiar pathogenesis hypothesis.

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