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Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report

BACKGROUND: Sclerosing mesenteritis is a rare fibroinflammatory disorder of unknown etiology that primarily affects the mesentery of the small intestine during late adult life. Only about twenty pediatric cases have been reported to date, but none has been reported in Chinese children. CASE PRESENTA...

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Autores principales: Liang, Cui-ping, Yang, Min, Chen, Pei-Yu, Geng, Lan-Lan, Li, Ding-You, Gong, Si-Tang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540191/
https://www.ncbi.nlm.nih.gov/pubmed/28764764
http://dx.doi.org/10.1186/s12887-017-0931-8
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author Liang, Cui-ping
Yang, Min
Chen, Pei-Yu
Geng, Lan-Lan
Li, Ding-You
Gong, Si-Tang
author_facet Liang, Cui-ping
Yang, Min
Chen, Pei-Yu
Geng, Lan-Lan
Li, Ding-You
Gong, Si-Tang
author_sort Liang, Cui-ping
collection PubMed
description BACKGROUND: Sclerosing mesenteritis is a rare fibroinflammatory disorder of unknown etiology that primarily affects the mesentery of the small intestine during late adult life. Only about twenty pediatric cases have been reported to date, but none has been reported in Chinese children. CASE PRESENTATION: A 5-year-old Chinese male presented with a 4-week history of recurrent bloating, abdominal pain, anorexia and vomiting. On admission, physical examination showed a severely distended abdomen. Biochemical investigations showed a slightly increased C-reactive protein, and normal serum levels of electrolytes and erythrocyte sedimentation rate. An abdominal film showed small intestine obstruction and massive ascites. An exploratory laparotomy revealed widespread inflammatory fibrotic adhesions between the bowel and the abdominal wall, thickening of the small bowel and massive ascites. During a prolonged hospital course, a 2nd surgery (4 months after 1st exploratory laparotomy) was performed in order to close the ileostomy and revealed that the bowel was still severely edematous, with very tight adhesions between the bowel and the abdominal wall. Histopathological examination of excised mesentery and nodules showed chronic inflammatory cell infiltration, fat necrosis and fibrosis. A diagnosis of sclerosing mesenteritis was finally established. Prednisolone at 2 mg/kg was started and he experienced rapid clinical improvement in 4 weeks. CONCLUSIONS: Sclerosing mesenteritis is extremely rare in children and often misdiagnosed due to its nonspecific clinical manifestation. It is important to be aware of sclerosing mesenteritis when evaluating a child with intractable abdominal pain, bloating, intestinal obstruction and massive ascites.
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spelling pubmed-55401912017-08-03 Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report Liang, Cui-ping Yang, Min Chen, Pei-Yu Geng, Lan-Lan Li, Ding-You Gong, Si-Tang BMC Pediatr Case Report BACKGROUND: Sclerosing mesenteritis is a rare fibroinflammatory disorder of unknown etiology that primarily affects the mesentery of the small intestine during late adult life. Only about twenty pediatric cases have been reported to date, but none has been reported in Chinese children. CASE PRESENTATION: A 5-year-old Chinese male presented with a 4-week history of recurrent bloating, abdominal pain, anorexia and vomiting. On admission, physical examination showed a severely distended abdomen. Biochemical investigations showed a slightly increased C-reactive protein, and normal serum levels of electrolytes and erythrocyte sedimentation rate. An abdominal film showed small intestine obstruction and massive ascites. An exploratory laparotomy revealed widespread inflammatory fibrotic adhesions between the bowel and the abdominal wall, thickening of the small bowel and massive ascites. During a prolonged hospital course, a 2nd surgery (4 months after 1st exploratory laparotomy) was performed in order to close the ileostomy and revealed that the bowel was still severely edematous, with very tight adhesions between the bowel and the abdominal wall. Histopathological examination of excised mesentery and nodules showed chronic inflammatory cell infiltration, fat necrosis and fibrosis. A diagnosis of sclerosing mesenteritis was finally established. Prednisolone at 2 mg/kg was started and he experienced rapid clinical improvement in 4 weeks. CONCLUSIONS: Sclerosing mesenteritis is extremely rare in children and often misdiagnosed due to its nonspecific clinical manifestation. It is important to be aware of sclerosing mesenteritis when evaluating a child with intractable abdominal pain, bloating, intestinal obstruction and massive ascites. BioMed Central 2017-08-01 /pmc/articles/PMC5540191/ /pubmed/28764764 http://dx.doi.org/10.1186/s12887-017-0931-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Liang, Cui-ping
Yang, Min
Chen, Pei-Yu
Geng, Lan-Lan
Li, Ding-You
Gong, Si-Tang
Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report
title Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report
title_full Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report
title_fullStr Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report
title_full_unstemmed Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report
title_short Sclerosing mesenteritis in a 5-year-old Chinese boy: a case report
title_sort sclerosing mesenteritis in a 5-year-old chinese boy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540191/
https://www.ncbi.nlm.nih.gov/pubmed/28764764
http://dx.doi.org/10.1186/s12887-017-0931-8
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