Mesenteric panniculitis

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

A wellness general practitioner visit revealed epigastric fullness on clinical palpation. The patient is asymptomatic.

Patient Data

Age: 70 years
Gender: Male
ultrasound

An apparent echogenic "mass" is identified within the epigastrium and supraumbilical abdomen with a horizontal orientation. It appears ill-defined, and non-encapsulated with no calcification or necrosis. There is no abnormal doppler flow. The mass is non-tender to ultrasound palpation.

ct

There is a demarcated, mesenteric pseudo mass with a misty attenuation. It is horizontally oriented along the jejunal mesenteric root. There is a mass effect with the peripherally displaced small and large bowel loops. There are no intralesional lymph nodes and no associated calcification. There is well identified fat halo surrounding the traversing mesenteric vessels (fat ring sign).

Case Discussion

The patient was completely asymptomatic and no further follow-up imaging or treatment was recommended unless the patient re-presented with symptoms.

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