Ceyhun AÇARI, Erbil ÜNSAL, Gülce HAKGÜDER, Alper SOYLU, Erdener ÖZER

Pediatric mesenteric panniculitis: three cases and a review of the literature

Mesenteric panniculitis is an inflammatory and fibrotic process in themesenteric adipose tissue with unknown etiology. It is rarely seen in general,particularly in children. Etiology is unknown, and pathophysiology is notclear. Factors that trigger the disease are malignancy, tuberculosis, trauma,medications and past surgical interventions. There is no pediatric case seriesin the literature except single case reports. This paper consists of 3 cases: Thefirst case is a 5-month-old girl, the youngest patient in the literature, who wasreferred to a pediatric surgeon with vomiting and abdominal distention. Shehad diffused intraabdominal fluid and mesenteric panniculitis documented byperioperative biopsy. The second case had acute abdominal pain with perforatedappendicitis, who eventually had mesenteric panniculitis in the evaluationof the pathological specimen. The last case had a diagnosis of polyarticularjuvenile idiopathic arthritis (JIA), successfully treated with etanercept, andhas been in remission for 2 years. Interestingly, in one of her routine visits, shehad pallor, anemia and renal failure. Bilateral hydronephrosis was detected.Magnetic resonance imaging (MRI) of the abdomen revealed retroperitonealfibrosis, and mesenteric panniculitis was the histopathological diagnosis.

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