Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2023; 11(14): 3304-3310
Published online May 16, 2023. doi: 10.12998/wjcc.v11.i14.3304
Idiopathic sclerosing mesenteritis presenting with small bowel volvulus in a patient with antiphospholipid syndrome: A case report
Papawee Chennavasin, Montri Gururatsakul
Papawee Chennavasin, Department of Surgery, Chulabhorn Hospital, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
Montri Gururatsakul, Department of Gastroenterology and Hepatology, Chulabhorn Hospital, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
Author contributions: Chennavasin P designed the research study and wrote the manuscript; Gururatsakul M revised the manuscript and performed language editing; and all authors read and approved the final manuscript.
Informed consent statement: Inform consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Papawee Chennavasin, MD, Surgeon, Department of Surgery, Chulabhorn Hospital, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Road Talat Bang Khen, Lak Si, Bangkok 10210, Thailand. papawee.che@cra.ac.th
Received: January 16, 2023
Peer-review started: January 16, 2023
First decision: March 13, 2023
Revised: March 16, 2023
Accepted: April 10, 2023
Article in press: April 10, 2023
Published online: May 16, 2023
Processing time: 120 Days and 2.7 Hours
Abstract
BACKGROUND

Sclerosing mesenteritis is a rare disorder involving inflammation of the mesentery. Its etiology remains unclear, but it is believed to be associated with previous abdominal surgery, trauma, autoimmune disorders, infection, or malignancy. Clinical manifestations of sclerosing mesenteritis are varied and include chronic abdominal pain, bloating, diarrhea, weight loss, formation of an intra-abdominal mass, bowel obstruction, and chylous ascites. Here, we present a case of idiopathic sclerosing mesenteritis with small bowel volvulus in a patient with antiphospholipid syndrome.

CASE SUMMARY

A 68-year-old female presented with recurrent small bowel obstruction. Imaging and pathological findings were consistent with sclerosing mesenteritis causing mesenteric and small bowel volvulus. Computed tomography scans also revealed pulmonary embolism, and the patient was started on a high dose of corticosteroid and a therapeutic dose of anticoagulants. The patient subsequently improved clinically and was discharged. The patient was also diagnosed with antiphospholipid syndrome after a hematological workup.

CONCLUSION

Sclerosing mesenteritis is a rare condition, and patients with no clear etiology should be considered for treatment with immunosuppressive therapy.

Keywords: Sclerosing mesenteritis; Mesenteric panniculitis; Small bowel obstruction; Antiphospholipid syndrome; Small bowel volvulus; Case report

Core Tip: In patients with sclerosing mesenteritis, any condition that causes chronic inflammation of mesenteric tissue should be investigated. Antiphospholipid syndrome may be linked with chronic thrombotic activity that can contribute to chronic ischemia of the mesentery. Patients with uncertain etiology should be considered for treatment with immunosuppressive therapy.