Advanced gastrointestinal malignancy or benign inflammatory disease? An unusual presentation of sclerosing mesenteritis. Report of a case.
The presentation of change of bowel habit, weight loss, muscle wasting, ascites, and the surgical appearance of "omental cake" are almost pathognomonic of advanced gastrointestinal malignancy. In our case, these symptoms represented a unique presentation of the condition sclerosing mesenteritis. Despite its rarity, the clinician should be aware of this "sheep in wolf's clothing," the clinical importance of which lies in the condition's benign and self-limiting course and imparts to the patient a prognosis and treatment that could not be further removed from that of advanced malignancy. Investigations that may be helpful to the surgeon in distinguishing the condition from carcinomatosis and avoiding unnecessary laparotomy include preoperative colonoscopy, barium enema, cytology of any ascites, and intraoperative frozen section biopsy. Treatment of the condition is conservative unless it has caused extrinsic bowel obstruction.
University Department of Surgery, Royal Hallamshire Hospital, Sheffield, United Kingdom.
J M
JM
Wilkinson
I
I
Nyamekye
M W
MW
Reed
S
S
Polacarz
D001201:Ascites / Q000209:etiology; D001706:Biopsy; D002908:Chronic Disease; D003113:Colonoscopy; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000473:pathology; D015436:Panniculitis, Peritoneal / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D011379:Prognosis; D012598:Sclerosis; D015431:Weight Loss