Viêm mạc treo xơ hóa

Viêm mạc treo xơ hóa Đỗ Hồng Trọng case Name of lesion Sclerosing mesenteritis : Viêm mạc treo xơ hóa Mesenteric panniculitis : inflammation over fibrosis Retractile mesenteritis: : predominance of fibrosis and retraction Misty mesentery � Mesenteric lipodystrophy: Fat necrosis Male/female:2,3/1 44.2% (n = 85) chronic while 35.4% (n = 68) presented acutely Sharma P, Yadav S, Needham CM, Feuerstadt P Sclerosing mesenteritis: a systematic review of 192 cases Clin J Gastroenterol 2017;10(2):103-111 doi:10.1007/s12328-017-0716-5 Symtom and Laboratory parameter - Normal - Abdominal pain, fever, weight loss, anorexia and abdominal tenderness - Bowel obstruction or ischemia Obstructive uropathy, renal failure 44.2% (n = 85) chronic while 35.4% (n = 68) presented acutely CRP and leukocystosis: elevated in 86.5% (n = 45) (n = 33, 17.2%), respectively Sharma P, Yadav S, Needham CM, Feuerstadt P Sclerosing mesenteritis: a systematic review of 192 cases Clin J Gastroenterol 2017;10(2):103-111 doi:10.1007/s12328-017-0716-5 Treatment and complication There were 41.7% (n = 80) surgically resected, 34.9% (n = 67) underwent medical treatment and 17.2% (n = 33) were managed conservatively When additional medical therapy was given, steroids (n = 18, 46.1%), azathioprine (n = 8, 20.5%), colchicine (n = 5, 12.8%) and cyclophosphamide (n = 3,7.7%) were the most frequently used medications 20.8% (n = 40) developed complications with the most common being bowel obstruction/ileus/ischemia (n = 10,23.8%),obstructive uropathy/renal failure(n = 10,23.8%), steroid related complications (n = 6, 14.3%),sepsis/respiratory failure(n = 6,14.3%) andvenous thromboembolism (n = 4, 10.0%) Other complications which included pericardial effusion (n = 2, 5.0%) and pulmonary edema (n = 1, 2.5%) were seen less frequently Sharma P, Yadav S, Needham CM, Feuerstadt P Sclerosing mesenteritis: a systematic review of 192 cases Clin J Gastroenterol 2017;10(2):103-111 doi:10.1007/s12328-017-0716-5 etiology and mechanism of disease • theory of abnormal post-surgical healing and ischemia to the mesentery Sharma P, Yadav S, Needham CM, Feuerstadt P Sclerosing mesenteritis: a systematic review of 192 cases Clin J Gastroenterol 2017;10(2):103-111 doi:10.1007/s12328-017-0716-5 Imaging Hyperattenuating fat (approximately -40 to -60 HU) Fat-ring sign or Fatty halo Tumoral pseudocapsule Soft-tissue nodules Differental diagnosis Sclerosing mesenteritis Metastasis of carcinoid tumor Mesenteric stranding + 76% Calcification 20% 70% Vessel displacement 40% + T2WI low Low to high Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Trước tiêm Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Sau tiêm dựng coronal Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Sinh thiết Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Trích dẫn Matsuki M, Inada Y, Nakai G, et al CT and MR features of sclerosing mesenteritis mimicking a mesenteric metastasis from the carcinoid tumor Radiat Med 2006;24(3):220-223 doi:10.1007/s11604-005-1405-8 Sharma P, Yadav S, Needham CM, Feuerstadt P Sclerosing mesenteritis: a systematic review of 192 cases Clin J Gastroenterol 2017;10(2):103-111 doi:10.1007/s12328-017-0716-5 ...case Name of lesion Sclerosing mesenteritis : Viêm mạc treo xơ hóa Mesenteric panniculitis : inflammation over fibrosis Retractile mesenteritis: : predominance