Retractile mesenteritis of the large bowel: report of a case and review of the literature.

We report herein the case of a 46-year-old woman found to have retractile mesenteritis of the rectosigmoid colon. A review of 52 cases of retractile mesenteritis of the large bowel collected from the literature is discussed following our case report. The average age of the patients was 54.5 years and the male: female ratio was 37:15. The majority of lesions (61.5%) were located in the rectosigmoid colon, with abdominal pain, an abdominal mass, constipation, and fever being the most common symptoms. The diagnosis was only able to be made at the time of laparotomy in 90.4% of the patients. The gross appearance at surgery was characterized by a thickened, shortened, and retractile mesentery, forming nodular masses involving the appendices epiploicae of the colon. Microscopically, fibrosis, inflammatory cell infiltrations, degeneration of the fatty tissue or fat necrosis, and aggregations of lipid-laden foamy cells were observed in most patients. The mass involving the colon was resected in 59.6% of the patients, but even external or bypass colostomy demonstrated favorable results.