Chennavasin P, Gururatsakul M. Idiopathic sclerosing mesenteritis presenting with small bowel volvulus in a patient with antiphospholipid syndrome: A case report. World J Clin Cases 2023; 11(14): 3304-3310 [PMID: 37274053 DOI: 10.12998/wjcc.v11.i14.3304]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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.
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.
