Sclerosing mesenteritis

Date Updated: 09/29/2021

Overview

Sclerosing mesenteritis, also called mesenteric panniculitis, occurs when the tissue (mesentery) that holds the small intestines in place becomes inflamed and forms scar tissue. Sclerosing mesenteritis is rare, and it's not clear what causes it.

Sclerosing mesenteritis can cause abdominal pain, vomiting, bloating, diarrhea and fever. But some people experience no signs and symptoms and may never need treatment.

In rare cases, scar tissue formed by sclerosing mesenteritis can block food from moving through your digestive tract. In this case, you may need surgery.

Symptoms

Symptoms of sclerosing mesenteritis include pain in your belly, vomiting, bloating, diarrhea and fever. Sometimes people don't have any symptoms.

Causes

The cause of sclerosing mesenteritis is not known.

Diagnosis

Tests and procedures used to diagnose sclerosing mesenteritis include:

Physical exam. During a physical exam, your doctor will look for clues that may help determine your diagnosis. For instance, sclerosing mesenteritis often forms a mass in your upper abdomen that can be felt during a physical exam.
Imaging tests. Imaging tests of your abdomen may reveal sclerosing mesenteritis. Imaging tests may include computerized tomography (CT) or magnetic resonance imaging (MRI).
Removing a sample of tissue for testing (biopsy). If you're experiencing sclerosing mesenteritis signs and symptoms, your doctor may recommend a biopsy to rule out other diseases and to make a definitive diagnosis. A biopsy sample may be collected by inserting a long needle through your skin or during surgery.

Before starting treatment, doctors will do a biopsy to confirm the diagnosis and rule out other possibilities, including certain cancers such as lymphoma and carcinoid.

Treatment

You may be diagnosed with sclerosing mesenteritis while you are receiving care for another condition. If you are not experiencing discomfort from sclerosing mesenteritis, you may not require treatment. Instead, your doctor may recommend periodic imaging tests to monitor your condition.

If you begin to experience signs and symptoms of sclerosing mesenteritis, you may choose to begin treatment.

Medications

Medications for sclerosing mesenteritis are intended to control inflammation. Medications may include:

Corticosteroids. Corticosteroids such as prednisone control inflammation. Corticosteroids can be used alone but are usually combined with other medications. They are not generally used more than three to four months because of side effects.
Hormone therapy. Hormone treatments such as tamoxifen may slow the growth of scar tissue. Tamoxifen (Soltamox) is typically combined with corticosteroids or other medications and may be used long term. Tamoxifen increases the risk of blood clots and is typically combined with a daily aspirin to reduce this risk. Progesterone (Prometrium) may be used as an alternative to tamoxifen, but it also has significant side effects.
Other drugs. Several other medications have been used to treat sclerosing mesenteritis, such as azathioprine (Imuran, Azasan), colchicine (Colcrys, Mitigare), cyclophosphamide and thalidomide (Thalomid).

Surgery

If sclerosing mesenteritis advances to block the flow of food through your digestive system, you may need surgery to remove the blockage.