Mesenteric panniculitis J034

Current RMA Instruments

Changes from previous Instruments

ICD Coding

• ICD-9-CM Code: 567.82
• ICD-10-AM Code: K65.8

Brief description

Mesenteric panniculitis is inflammation of the fat cells of the mesentery of the small intestine and colon.  The mesentery is a continuous fold of tissue that supports the intestines and attaches them to the abdominal wall.  The condition is rare and is generally associated with chronic inflammation with scarring and a range of abdominal symptoms, including pain.

Confirming the diagnosis

The condition is usually discovered incidentally on abdominal imaging for evaluation of nonspecific abdominal or systemic symptoms.  A definitive diagnosis requires histologic evaluation to rule out other aetiologies. A laparoscopy or laparotomy is usually necessary to obtain tissue.

The relevant medical specialist is a general surgeon or gastroenterologist.

Additional diagnoses that are covered by SOP

• Mesenteric lipodystrophy
• Sclerosing mesenteritis

Conditions that are excluded from SOP

• Sclerosing encapsulating peritonitis^#
• Retroperitoneal fibrosis^#
• Peritoneal adhesions*
• Peritonitis^#
• Ormond disease^#

* another SOP applies

^# non-SOP condition

Clinical onset

The most common presenting feature is abdominal pain.  Systemic symptoms may include fever, malaise and weight loss.  Altered bowel habits with either constipation or diarrhea may also occur.  An abdominal mass may be felt in up to half of patients.  Symptoms may be present for a long time (up to years) before the diagnosis is made.  The non-specific nature of symptoms may make establishing the time of clinical onset difficult.

Clinical worsening

The condition usually has a benign, stable, or slowly progressive course.  Worsening may be evidenced by the development of complications such as bowel obstruction, renal impairment or mesenteric ischaemia. Treatment is aimed at symptom relief.  Available therapies have not been shown to alter the course of the disease.