An Unusual Presentation of Mesenteric Panniculitis

Mesenteric panniculitis is a rare disorder characterized by a tumor-like expansion of the mesentery due to variable degrees of fat necrosis, chronic inflammation and fibrosis. Its pathophysiology remains unclear despite the description of associations with inflammatory disorders or malignancies, especially lymphomas. The disease remains asymptomatic in 30-50% of cases, and the most common clinical presentations are abdominal pain, palpable abdominal mass or intestinal obstruction. Most patients present a benign, slowly progressive course, and the outcome of the disease is usually favorable. Nevertheless, in about 20% of patients, mesenteric panniculitis is associated with significant morbidity and a chronic debilitating course. We report a case of this poorly known entity, which presented as a systemic disease with severe constitutional manifestations and rapid deterioration of the general condition of the patient, which made diagnosis difficult.