Retractile mesenteritis after resection of Meckel's diverticulum

History and admission findings: A 22-year-old man who had never been seriou sly ill previously was admitted because of epigastric pain and vomiting of bile. Investigations: He had slight pain on pressure over the epigatric region an d decreased intestinal peristaltic sounds. There was evidence of ileus of t he small intestine both by ultrasound and radiologically. Treatment and course: As the patient's condition deteriorated on conservati ve treatment, an exploratory laparotomy was performed. It revealed an invag inated Meckel's diverticulum. Ileus of the small intestine recurred postope ratively, requiring relaparotomy. A glued-together volvulus of the small in testine had to be resected, even though there was no sign of an anastomotic leak. But there was no postoperative improvement. A third operation reveal ed a clearly shortened and 3 cm-thick mesentery which showed a stage III re tractile mesenteritis. Histological reexamination of the specimens resected at the previous operations revealed stage I and II retractile mesenteritis . The patient's condition slowly improved on high doses of corticosteroids and he ultimately became symptom-free. Conclusions: Retractile mesenteritis is a very rare benign disease of the m esentery, almost always causing abdominal pain and diagnosed histologically by exploratory laparotomy. Administration of corticosteroids is the treatm ent of choice.