Relationship between abdominal trauma or surgery and mesenteric panniculitis

Abstract

Mesenteric panniculitis is a rare disease characterized by chronic non-specific inflammation of mesenteric fat tissue. Several etiologic and/or associated factors have been reported in the literature so far. Although trauma or surgery is one of the potential etiologic factors for mesenteric panniculitis, to the best of our knowledge, no strong correlation has been shown in the literature until now.

Key Words: Mesentery, Pathology, Mesenteric panniculitis, Trauma, Surgery

TO THE EDITOR

We read with a great interest the article “Mesenteric panniculitis: Various presentations and treatment regimens” by Issa et al[1] in the August issue of the World Journal of Gastroenterology.

Mesenteric panniculitis is a rare chronic inflammatory disorder of adipose tissue of the intestinal mesentery. This entity has several different names, such as mesenteric Weber-Christian disease, fibrosing mesenteritis, retractile mesenteritis, mesenteric lipodystrophy, and sclerosing mesenteritis. Its etiology still remains unclear, although a variety of possible causative and associated factors, such as infective and autoimmune causes, vascular insufficiency, prior abdominal surgery, and malignancy, have been reported[1-4].

Issa et al[1] reported that 84% of patients with mesenteric panniculitis have a history of abdominal trauma or surgery as its etiological factor[2]. However, the actually reported rate of trauma or surgery as an etiologic factor is 4.76% rather than 84%[2]. A same mistaken rate of 84% has also been reported in a case series[3], showing that trauma and surgery are closely correlated with mesenteric panniculitis. Upon reviewing the literature, we were not able to find this strong correlation in any study.

Several studies are available on the etiology of mesenteric panniculitis[1-4]. Daskalogiannaki et al[4] reported that mesenteric panniculitis is associated with 69.3% of malignancies, such as lymphoma, breast cancer, colon cancer, lung cancer and melanoma, demonstrating that mesenteric panniculitis is an associated and/or causative factor for malignancies. Although trauma or surgery is one of the potential etiologic factors, to the best of our knowledge, no strong correlation has been shown in the literature until now.