Mesenteric panniculitis and Duodenal third part diverticulum
- A 55 years old man presented with vague upper abdominal pain to ER department
- A rather well defined mass-like area of increased fat density seen in the small bowel ( jejunal) mesentery at the upper central abdominal cavity, with ground glass or misty mesentery appearance.
- It surrounds the mesenteric vessels without any displacement.
- A saccular outpouching from the 3rd part of the duodenum containing fecal matter.
- Mesenteric panniculitis is an idiopathic chronic nonspecific inflammation involving the adipose tissue of the bowel mesentery.
- It mostly affects people older than 50 years.
- It could be self-limiting or it could progress to a fibrotic form named retractile mesenteritis.
- Duodenal diverticulum is a commonly missed diagnosis, especially in thin patients with a paucity of intra- abdominal fat.
- You must have a systematic approach in all body parts.
- You must look at all structures in a systematic way, so you will never miss a pathology
