asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2024-001asurgery-433Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCE | PRACTICEСклерозирующий мезентерит как хирургическая проблема: обзор литературы и собственное клиническое наблюдениеSclerosing mesenteritis as a surgical problem: a review of the literature and own clinical observationhttps://orcid.org/0000-0003-4488-9123БолдинБ. В.BogachevV. Yu.

Болдин Борис Валентинович - д.м.н., профессор, заведующий кафедрой факультетской хирургии №2.

117997 , Москва, ул. Островитянова, д. 1

Boris V. Boldin - Dr. Sci. (Med.), Professor, Head of the Department of Faculty Surgery No. 2.

1, Ostrovityanov St., Moscow, 117997

facultysurgery@gmail.comhttps://orcid.org/0000-0002-3940-0787БогачевВ. Ю.BoldinB. V.

Богачев Вадим Юрьевич - д.м.н., профессор, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; научный руководитель, Первый флебологический центр.

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31

Vadim Yu. Bogachev - Dr. Sci. (Med.), Professor, Department of Faculty Surgery No. 2, Pirogov RNRMU; Scientific Supervisor, First Phlebological Center LLC.

1, Ostrovityanov St., Moscow, 117997; 31, Dmitry Ulyanov St., Moscow, 117447

vadim.bogachev63@gmail.comhttps://orcid.org/0000-0002-6976-7678ГолосницкийП. Ю.GolosnitskiyP. Yu.

Голосницкий Павел Юрьевич - к.м.н., доцент, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; руководитель центра сосудистой хирургии, ЦКБ Святителя Алексия Митрополита Московского

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31

Pavel Yu. Golosnitskiy - Cand. Sci. (Med.), Associate Professor, Department of Faculty Surgery No. 2, Pirogov RNRMU; Head of the Vascular Surgery Center, CCH of the Moscow Patriarchate of St Alexy.

1, Ostrovityanov St., Moscow, 117997; 31, Dmitry Ulyanov St., Moscow, 117447

hirurg1978@mail.ruhttps://orcid.org/0000-0002-6262-4770ТуркинП. Ю.TurkinP. Yu.

Туркин Павел Юрьевич - к.м.н., доцент, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; врач-хирург операционного блока, ЦКБ Святителя Алексия Митрополита Московского.

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31

Pavel Yu. Turkin - Cand. Sci. (Med.), Associate Professor, Department of Faculty Surgery No. 2, Pirogov RNRMU; Doctor-Surgeon of the Operating Unit, CCH of the Moscow Patriarchate of St Alexy.

1, Ostrovityanov St., Moscow, 117997; 31, Dmitry Ulyanov St., Moscow, 117447

pavelturkin@gmail.comhttps://orcid.org/0000-0003-4298-950XДизенгофИ. М.DizengofI. M.

Дизенгоф Игорь Михайлович - к.м.н., ассистент, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; заместитель главного врача по хирургии, ЦКБ Святителя Алексия Митрополита Московского.

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31

Igor M. Dizengof - Cand. Sci. (Med.), Аssistant, Department of Faculty Surgery No. 2., Pirogov RNRMU; Deputy Chief Physician for Surgery, CCH of the Moscow Patriarchate of St Alexy;

1, Ostrovityanov St., Moscow, 117997; 27, Leninsky Ave, Moscow, 119071

idizengof@yandex.ruКобзаревД. А.KobzarevD. A.

Кобзарев Дмитрий Алексеевич - к.м.н., руководитель отделения лучевой диагностики.

119071, Москва, Ленинский проспект, д. 27

Dmitriy A. Kobzarev - Cand. Sci. (Med.), Head of the Department of Radiation Diagnostics.

27, Leninsky Ave., Moscow, 119071

sem0102@yandex.ruhttps://orcid.org/0000-0003-4265-577XЦуканВ. Ю.TsukanV. Yu.

Цукан Валерия Юрьевна - студент-субординатор, староста студенческого научного кружка, кафедра факультетской хирургии №2.

117997, Москва, ул. Островитянова, д. 1; Москва, Ленинский проспект, д. 27

Valeriia Yu. Tsukan - Student-Subordinator, Head of the student scientific circle, Department of Faculty Surgery No. 2.

1, Ostrovityanov St., Moscow, 117997

valeriya_tskn@mail.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical University; First Phlebological Center, Limited Liability CompanyRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; Первый флебологический центрРоссияPirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; Центральная клиническая больница Святителя Алексия Митрополита МосковскогоРоссияPirogov Russian National Research Medical University; Central Clinical Hospital of the Moscow Patriarchate of St. AlexyRussian FederationЦентральная клиническая больница Святителя Алексия Митрополита МосковскогоРоссияCentral Clinical Hospital of the Moscow Patriarchate of St. AlexyRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202417052024211136156Copyright © Болдин Б.В., Богачев В.Ю., Голосницкий П.Ю., Туркин П.Ю., Дизенгоф И.М., Кобзарев Д.А., Цукан В.Ю., 20242024Болдин Б.В., Богачев В.Ю., Голосницкий П.Ю., Туркин П.Ю., Дизенгоф И.М., Кобзарев Д.А., Цукан В.Ю.Bogachev V.Y., Boldin B.V., Golosnitskiy P.Y., Turkin P.Y., Dizengof I.M., Kobzarev D.A., Tsukan V.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/433

Проблеме изучения патологии брыжеечного жира тонкой кишки в практике хирурга до настоящего времени уделяется недостаточно внимания. Остается нерешенным ряд вопросов, касающихся этиологии и патогенеза заболеваний брыжейки, их возможной связи с доброкачественными и злокачественными заболеваниями, методов их лабораторной и инструментальной диагностики, возможных вариантов консервативного и хирургического лечения, а также систематизации и структурирования классификации. Одним из малоизученных представителей заболеваний брыжейки тонкой кишки продолжает оставаться склерозирующий мезентерит, характеризующийся различными гистологическими вариантами поражения брыжеечного жира и разнообразной неспецифической клинической картиной. В совокупности это приводит к определенным трудностям диагностики, обращаемости пациентов к врачам различного профиля, что в конечном итоге отрицательным образом отражается на результатах лечения и может приводить к социальной дезадаптации и возможной инвалидизации. Сообщения о встречаемости данной патологии в медицинской литературе немногочисленны и, как правило, описывают исключительно редкие клинические случаи. Однако в последние годы частота выявления этой патологии продолжает неуклонно расти, что связано с прогрессирующим старением населения, высокой степенью хирургической активности в отношении ургентных заболеваний органов брюшной полости, совершенствованием методов инструментальной диагностики. Вопросы этиологии, патогенеза, дифференциальной диагностики данного заболевания и его возможной связи с паранеопластическим процессом в настоящее время продолжают вызывать дискуссии. Дальнейшее накопление клинического опыта, лучшее понимание патогенеза заболевания, совершенствование визуализационных методик позволит разработать более четкие диагностические и клинические критерии, сузить диагностический поиск и в конечном итоге улучшить и стандартизировать лечение. В статье приведен обзор литературы, посвященный этой редкой хирургической патологии, представлено собственное клиническое наблюдение, рассмотрены вопросы диагностики и варианты лечения данного заболевания.

The problem of studying the pathology of mesenteric fat of the small intestine in surgical practice has not yet received enough attention. A number of questions remain unresolved regarding the etiology and pathogenesis of mesenteric diseases, their possible connection with benign and malignant diseases, methods of their laboratory and instrumental diagnosis, possible options for conservative and surgical treatment, as well as systematization and structuring of the classification. One of the poorly studied representatives of diseases of the mesentery of the small intestine continues to be Sclerosing mesenteritis, characterized by various histological variants of damage to mesenteric fat and a varied nonspecific clinical picture. Taken together, this leads to certain difficulties in diagnosis, patients seeking access to doctors of various profiles, which ultimately negatively affects the results of treatment and can lead to social maladjustment and possible disability. Reports on the occurrence of this pathology in the medical literature are few and, as a rule, describe extremely rare clinical cases. However, in recent years, the frequency of detection of this pathology continues to grow steadily, which is associated with the progressive aging of the population, a high degree of surgical activity in relation to urgent diseases of the abdominal organs, and the improvement of instrumental diagnostic methods. Issues of etiology, pathogenesis, differential diagnosis of this disease and its possible connection with the paraneoplastic process currently continue to cause debate. Further accumulation of clinical experience, a better understanding of the pathogenesis of the disease, and improvement of imaging techniques will allow us to develop clearer diagnostic and clinical criteria, narrow the diagnostic search and, ultimately, improve and standardize treatment. The article provides a review of the literature on this rare surgical pathology, presents our own clinical observation, and discusses diagnostic issues and treatment options for this disease.

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The authors declare that there are no conflicts of interest present.