Primary and secondary mesenteric panniculitis: A descriptive cohort study with clinical and prognostic implications

BACKGROUND: Mesenteric panniculitis is a chronic inflammation of the mesenteric adipose tissue, of uncertain clinical significance and with a possible link to malignancy. This study evaluated the clinical, radiological and prognostic characteristics of primary and secondary forms in an internal medicine cohort. METHODS: A retrospective cohort of adults with a radiological diagnosis of mesenteric panniculitis (2013-2024), analyzing demographic data, comorbidities, clinical presentation, radiological findings and clinical course. Cases were classified as primary or secondary when associated malignancy, autoimmune disease, or infection was present. RESULTS: One hundred eleven patients included (50% women; mean age 72.2±13.1 years). 61.3% were primary and 38.7% secondary. 31.5% were asymptomatic; abdominal pain was the most common symptom. Mesenteric thickening was the predominant radiological finding. During follow-up, 85.6% remained clinically stable. Overall mortality was 8.1%, slightly higher in secondary forms, mainly those associated with neoplasms, with no significant differences compared to primary cases. CONCLUSIONS: Mesenteric panniculitis mainly affected older adults, with a generally indolent course in primary forms, whilst secondary forms showed greater comorbidity.