Pediatr Gastroenterol Hepatol Nutr.  2016 Jun;19(2):143-146. 10.5223/pghn.2016.19.2.143.

Mesenteric Panniculitis in a Thirteen-Year-Old Korean Boy Treated with Prednisolone: A Case Report

• Bae SH
• Park SJ
• Kim WS
• Lee MW
• Kim JS

• KMID: 2328176
• DOI: http://doi.org/10.5223/pghn.2016.19.2.143

Abstract

Pediatric mesenteric panniculitis is an extremely rare disease of unknown etiology characterized by chronic inflammation, fat necrosis, and fibrosis in the mesenteric adipose tissue. A previously healthy 13-year-old boy was admitted because of right upper abdominal pain. An abdominal computed tomography scan revealed increased attenuation and enhancement in the left upper abdominal omental fat and anterior peritoneal wall thickening. A laparoscopic biopsy showed mesenteric panniculitis with chronic inflammation, adiponecrosis, and septal fibrosis. Serological tests for autoimmune diseases, nested polymerase chain reaction for Mycobacterium tuberculosis, and special immunohistochemical stains for malignancy were all negative. Symptomatic improvement and improved abnormal findings were achieved after an 8-month treatment with prednisolone according to a follow-up abdominal computed tomography scan. Here, we report a case of pediatric mesenteric panniculitis treated with prednisolone.

Keyword

Mesenteric panniculitis; Prednisolone; Child

MeSH Terms

Abdominal Pain
Adipose Tissue
Adolescent
Autoimmune Diseases
Biopsy
Child
Coloring Agents
Fat Necrosis
Fibrosis
Follow-Up Studies
Humans
Inflammation
Male*
Mycobacterium tuberculosis
Panniculitis, Peritoneal*
Polymerase Chain Reaction
Prednisolone*
Rare Diseases
Serologic Tests
Coloring Agents
Prednisolone

Figure

• 

  Fig. 1 (A) Initial abdominal computed tomography (CT) scan showed increased attenuation and enhancement of omental fat as well as anterior peritoneal wall thickening and enhancement (arrows). (B) Follow-up abdominal CT scan at 8 months showed marked improvement in intra-abdominal fat attenuation.

• 

  Fig. 2 Mesenteric biopsy showed nodular panniculitis, septal fibrosis with hyalinization, chronic inflammation, and fat necrosis (A: H&E, ×200; B: Masson's trichrome, ×100).

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