[Retractile mesenteritis after resection of Meckel's diverticulum].

HISTORY AND ADMISSION FINDINGS: A 22-year-old man who had never been seriously ill previously was admitted because of epigastric pain and vomiting of bile.

INVESTIGATIONS: He had slight pain on pressure over the epigatric region and decreased intestinal peristaltic sounds. There was evidence of ileus of the small intestine both by ultrasound and radiologically.

TREATMENT AND COURSE: As the patient's condition deteriorated on conservative treatment, an exploratory laparotomy was performed. It revealed an invaginated Meckel's diverticulum, Ileus of the small intestine recurred postoperatively, requiring relaparotomy. A glued-together volvulus of the small intestine had to be resected, even though there was no sign of an anastomotic leak. But there was no postoperative improvement. A third operation revealed a clearly shortened and 3 cm-thick mesentery which showed a stage III retractile mesenteritis. Histological re-examination of the specimens resected at the previous operations revealed stage I and II retractile mesenteritis. The patient's condition slowly improved on high doses of corticosteroids and he ultimately became symptom-free.

CONCLUSIONS

Retractile mesenteritis is a very rare benign disease of the mesentery, almost always causing abdominal pain and diagnosed histologically by exploratory laparotomy. Administration of corticosteroids is the treatment of choice.