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BMJ Case Rep ; 12(7)2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31289157

RESUMO

Sclerosing mesenteritis is a rare benign disease presenting with chronic inflammation of the mesenteric adipose tissue and variable degrees of fibrosis. A 47-year-old black man presented to the emergency department with symptoms of small bowel obstruction, requiring surgical treatment. The laparotomy revealed a stenosis of the distal ileum with mesenteric thickening and an enterectomy was performed. The postoperative period was complicated by the maintenance of bowel obstruction. The patient underwent a second laparotomy, in which the fibrosing process of the mesentery was much aggravated, and an ileo-colic resection was needed. After knowledge of the histological diagnosis, the patient was started on immunomodulators with clinical improvement. At 26 months of follow-up, patient is asymptomatic under medical treatment. This is the first report, to our knowledge, of a patient with progressive fibrosis in such short period of time requiring surgical re-intervention for bowel obstruction, owing to sclerosing mesenteritis.


Assuntos
Obstrução Intestinal/etiologia , Mesentério/patologia , Paniculite Peritoneal/tratamento farmacológico , Paniculite Peritoneal/patologia , Diagnóstico Diferencial , Humanos , Fatores Imunológicos/uso terapêutico , Obstrução Intestinal/cirurgia , Laparotomia/métodos , Masculino , Pessoa de Meia-Idade , Paniculite Peritoneal/diagnóstico , Complicações Pós-Operatórias/patologia , Resultado do Tratamento
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