Author(s): Akram S, Pardi DS, Schaffner JA, Smyrk TC
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Abstract BACKGROUND & AIMS: Sclerosing mesenteritis is a rare non-neoplastic disease that affects the small bowel mesentery with chronic fibrosing inflammation. There are few data on the natural history and therapeutic options for this condition. METHODS: We performed a retrospective and prospective study to describe the clinical characteristics, therapy, and outcome of all cases of sclerosing mesenteritis diagnosed at the Mayo Clinic, Rochester, from 1982-2005. RESULTS: Ninety-two cases were identified; 70\% were male, with a median age of 65 years (interquartile range, 55-72). Common presenting symptoms included abdominal pain in 70\%, diarrhea in 25\%, and weight loss in 23\%. Treatment included medical therapy alone in 26\%, surgery alone in 13\%, surgery followed by medical therapy in 9\%, and 52\% received no treatment. Ten percent responded to surgery alone, 20\% responded to additional medical treatment after surgery, and 38\% responded to medical therapy alone. Tamoxifen in combination with prednisone was used in 20 patients, and 60\% improved. Non-tamoxifen-based regimens were used in 12 patients, and 8\% improved. Eighteen deaths were noted during the study period, and 17\% were attributed to complications of sclerosing mesenteritis or its treatment. CONCLUSIONS: Although a relatively benign condition, sclerosing mesenteritis can have a prolonged debilitating course with a fatal outcome. Our results suggest that symptomatic patients might benefit from medical therapy, particularly tamoxifen and prednisone combination treatment. Long-term follow-up is needed to substantiate these results.
This article was published in Clin Gastroenterol Hepatol
and referenced in Journal of Clinical Case Reports