Mesenteric Panniculitis with Raised Alanine Transaminase Levels: A Rare Case Report from Pakistan

Mesenteric panniculitis (MP) is a rare condition that encompasses a spectrum of disease processes characterized by degeneration, inflammation, and scarring of the adipose tissue of the mesentery. The etiology of MP remains unknown; although various causes have been suggested and it has been seen to occur independently as well as in association with other disorders. The clinical manifestations of MP vary over a spectrum, and most patients actually experience no discomfort at all. When present, these clinical presentations vary according to the stage of the disease and may include general symptoms like abdominal pain and weight loss or more specific ones such as an abdominal mass, peritoneal irritation, and ascites. CT findings have emerged to be the gold standard in diagnosis, wherein MP is characterized by localized mesenteric thickening and stranding covering the blood vessels with a characteristic ‘halo sign’, in which the fat around the lymph nodes and blood vessels is spared. Here, we present the case of a 45-year-old male patient who reported to a private hospital in Karachi, Pakistan with non-specific complaints of abdominal pain and vomiting and typical CT and histopathology findings of MP on investigation, as well as abnormally raised alanine transaminase (ALT) levels.