Abstract
Sclerosing mesenteritis (SM) is a rare benign disorder characterized by chronic non-specific inflammation involving the adipose tissue of the bowel mesentery. It is distinguished histologically and radiologically by varying amounts of fibrosis, chronic inflammation, and fat necrosis. Numerous associated conditions have been variably described, including malignancy, recent abdominal surgery, and systemic inflammatory diseases. Since the SM lacks specific manifestation and typical signs, the patients are often misdiagnosed.
We present a rare case of multifocal involvement of SM in an elderly patient. A male patient presented with recurrent abdominal pain and diarrhea over a few months. Computed tomography (CT) and Magnetic resonance imaging (MRI) showed an ill-defined mass in the region of root of mesentery and in the left perinephric region. The lesions were discrete. CT guided biopsy was done, and the diagnosis of SM was confirmed. Medical management with steroids was initiated. The patient recovered symptomatically. Follow up imaging at six months and nine years revealed resolution of the lesion.
To our knowledge, there is no case reporting multifocal presentation of SM. In this paper, we provide an overview of the literature relevant to the diagnosis, etiology, and management of this unique condition.

Key words: Sclerosing mesenteritis imaging findings