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Extensive retractile mesenteritis of the rectum and left colon associated with ischemic colitis

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Background: Retractile mesenteritis is a rare inflammatory and fibrotic process of the mesenteric tissue that affects more commonly the small intestine. Clinical presentation and investigations are unspecific, which renders the condition a diagnostic challenge for surgeons and internists. Only the anatomopathological examination can confirm the diagnosis. There is not a specific treatment for this disease. Surgery remains a controversial therapy. Case report: We present an unusual case of sclerosing mesenteritis of the rectum and left colon in a 60 years old female patient. She presented rectal bleeding, diarrhea, fatigue, lower abdominal pain and a palpable tender mass in the left flank.
The preoperative imagistic evaluation (colonoscopy, CT scan) fail to prove the diagnosis. We have performed a laparotomy that revealed diffuse fibrotic infiltration of the mesorectum and the mesentery of the left colon that obviously affected the intestinal vascular supply associated with rigidity of the rectal and left colon wall. Histological examination showed diffuse fibrotic infiltration of the mesentery associated with erosive colitis.

Conclusions: Retractile mesenteritis that affects rectum and large intestine is very rare. We discussed clinical presentation and treatment.

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