Sclerosing Mesenteritis Revealed by Rectal Bleeding in a 41-Year-Old Woman: The Contribution of Diagnostic Imaging

Sclerosing mesenteritis is a rare and often misdiagnosed inflammatory condition of the mesenteric fat with nonspecific symptoms. We report the case of a 41-year-old woman admitted for profuse rectal bleeding, an exceptional resentation of this disease. Endoscopic findings were inconclusive, while CT angiography revealed a retractile, hypodense mass at the mesenteric root encasing the superior mesenteric vessels, with associated varices, mesenteric fat infiltration, and bowel wall thickening. These features were highly suggestive of advanced sclerosing mesenteritis. Surgical exploration confirmed the diagnosis, and a right hemicolectomy was performed with good clinical evolution. Rectal bleeding was attributed to venous compression and collateral mesenteric varices. This case highlights the crucial role of CT in diagnosing sclerosing mesenteritis and guiding treatment, especially in atypical presentations that may mimic malignancy.