Mesenteric Panniculitis

The fatty tissues of the retroperitoneum may undergo a series of changes characterized by destruction of the fat, appearance of lipophages, calcification, fibrosis, and tumorlike formation. To these changes there have been applied many names, among the most well known of which are mesenteric panniculitis, isolated lipodystrophy, retractile mesenteritis, sclerosing lipogranuloma, and xanthogranuloma. Retroperitoneal fibrosis may also be a manifestation of this type of change. This process may be started apparently by any one of a number of insults to the fat, ranging from bacterial infection through mechanical trauma. Once begun, the factors determining the extent, position, and progress of the changes are poorly understood. In most instances, an abdominal mass provokes interest and leads to surgical exploration. This lesion requires no therapy. When intestinal obstruction or ureteral obstruction occurs, relief by surgery is indicated. It is suggested that cognizance be taken of the possibility that inadequate antibiotic treatment or surgical trauma, plays a role in this disease.