TWO CASES OF MESENTERIC PANNICULITIS CAUSING EARLY POSTOPERATIVE BOWEL OBSTRUCTION

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  • 腸閉塞の原因となった術後早期腸間膜脂肪織炎の２例

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Case 1 involved a 70-year-old man who developed bowel obstruction on the 7th day after ileo-cecal resection. A hard mass was palpated in the right side of his abdomen. An abdominal CT scan showed thickening of the mesenteries and elevated density of the fat tissue. His symptoms improved immediately after starting intravenous injection with dexamethasone (8mg/day) on the 30th postoperative day, and he left the hospital on the 40th postoperative day.<BR>Case 2 involved a 72-year-old man who developed bowel obstruction on the 7th day after left/colectomy. Upper gastrointestinal radiography showed poor peristaltic movement of the small intestine. A hard mass was palpable on the left side of his abdomen. An abdominal CT scan showed elevated density of mesenteric fat. He symptoms improved gradually by the treatment with nasal-gastric tube, without using steroids. He started eating on the 37th day, and was discharged from the hospital on the 47th postoperative day.<BR>Mesenteric pannniculitis can cause early postoperative bowel obstruction, in which formation of a hard and palpable mesenteric mass and absence of bacterial infection are characteristic. Although the cause has been unknown, we found, from the previos reports, that the disease they often develops in men after surgery for colo-rectal cancer. We can avoid unnecessary surgery if this disease is kept in mind as a probable cause of early postoperative bowel obstruction.

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