Sclerosing Mesenteritis: A Concise Clinical Review for Clinicians

Dr. Bibek Saha, an Internal Medicine Resident Physician at Mayo Clinic in Rochester, MN, reviews his article appearing in the May 2024 issue of Mayo Clinic Proceedings, where he describes the history risk factors/associations, diagnostic workup and treatment options for sclerosing mesenteritis, an idiopathic non-neoplastic condition that is characterized by chronic fat necrosis, inflammation, and fibrosis most commonly of the small bowel mesentery. While many patients are asymptomatic, clinical features and complications are related to the mass effect resulting from the inflammation and fibrosis. Indeed, severe cases of SM can be complicated by bowel obstruction, and mesenteric vessel thrombosis/ischemia. While the preferred modality for diagnosis is abdominal computed tomography, the workup becomes nuanced as malignant involvement of the mesentery can have similar characteristics on imaging. Additionally, given the rarity of this disease, there are currently no standardized guideline-directed diagnostic and management recommendations. Available at: mayocl.in/3U1uR1j