title: Sclerosing mesenteric panniculitis in a young patient : common cause of diagnostic dilemma and treatment refractoriness.
abstract: BACKGROUND
  Sclerosing mesenteric panniculitis (SMP) is an idiopathic chronic fibroinflammatory disorder of the intra-abdominal fat.
  
  
  METHODS
  Herin, we report a case of SMP, involving the omentum, mesentery and peri-colic fat in a 18 year old male, who presented with significant and recurrent abdominal distension for 4.5 years. Computed tomogram revealed ascites, with nodular and irregular omental thickening and foci of calcification. Non-specific radiological and histological features made an accurate diagnosis extremely difficult. After a thorough work up and exclusion of other differentials, diagnosis of a nodular SMP (Weber Christian disease) was given. After showing resistance to chemotherapeutic agents, slow response was noted with cyclophosphamide, followed by rapid symptomatic improvement with mesenterectomy.
  
  
  CONCLUSIONS
  SMP is an uncommon benign mesenteric/ omental inflammation, and is a diagnosis of exclusion. As treatment refractoriness is common, management should be individualized and continued for along period. Surgical omentectomy may be helpful.
authors.forename: R
authors.initials: R
authors.lastname: Metha
authors.forename: G P S
authors.initials: GP
authors.lastname: Gahlot
authors.forename: P
authors.initials: P
authors.lastname: Das
authors.forename: G
authors.initials: G
authors.lastname: Jindal
authors.forename: V P
authors.initials: VP
authors.lastname: Mouli
authors.forename: K S
authors.initials: KS
authors.lastname: Madhusudhan
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.forename: S
authors.initials: S
authors.lastname: Pal
authors.forename: V
authors.initials: V
authors.lastname: Ahuja
authors.forename: S
authors.initials: S
authors.lastname: DattaGupta
mesh_terms: D000293:Adolescent; D001706:Biopsy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D009852:Omentum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D015436:Panniculitis, Peritoneal / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents