A diagnostic dilemma: Pedunculated mesenteric lipodystrophy mimicking Meckel's diverticulum. A case report and literature review.
CT
Computed tomography
Meckel’s diverticulum
Mesenteric lipodystrophy
Mesenteric panniculitis
Sclerosing mesenteritis
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
26
03
2020
revised:
24
05
2020
accepted:
25
05
2020
pubmed:
17
6
2020
medline:
17
6
2020
entrez:
17
6
2020
Statut:
ppublish
Résumé
Mesenteric lipodystrophy is a rare fibroinflammatory disease of unknown origin with clinical and radiological non specific findings. The case of a 42-years-old man affected by a pedunculated mesenteric lipodystrophy mimicking Meckel's diverticulum is reported. Clinical, imaging and histological findings are discussed. Mesenteric lipodystrophy affects the mesenteric fat of the abdomen with a typical diffuse thickening of the mesentery, nodular thickening of the mesenteric root and presence of mass-like lesions. Ultrasound (US) and Multiphasic Computed Tomography (CT) represent the main imaging tools used for diagnosis. Clinical and imaging findings can mimick other pathological conditions affecting the mesenteric fat tissue. Contrast enhanced CT is the most accurate imaging technique for diagnosing mesenteric lipodystrophy due to the high panoramicity and accuracy with multiplanar imaging. Multiphasic technique helps to characterize the lesion and to recognize vascular anatomy. Oral administration of iodinated contrast medium may help to assess the relationship with bowel loops. All these diagnostic elements are crucial for the surgical timing and approach. Due to the heterogeneous mesenteric involvement, the nonspecific CT findings and the high number of diseases for differential diagnosis, the detection of mesenteric lipodystrophy is challenging and requires early clinical suspicion. An histological examination is always necessary.
Identifiants
pubmed: 32544826
pii: S2210-2612(20)30385-0
doi: 10.1016/j.ijscr.2020.05.083
pmc: PMC7298552
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
183-187Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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