CLINICAL REPERCUSSIONS OF MESENTERIC FIBROSIS AND INDICATION OF PROPHYLACTIC SURGERY

Abstract

Introduction: Mesenteric fibrosis is a rare and complex condition characterized by the formation of fibrous tissue in the mesentery, which can lead to changes in bowel anatomy and function. This fibrosis can result in serious complications, such as bowel obstruction, mesenteric ischemia, and chronic abdominal pain. The pathogenesis of mesenteric fibrosis is not fully understood, but it is believed that autoimmune, inflammatory, and infectious factors may be involved. Early diagnosis is challenging, since symptoms can be vague and often confused with other abdominal conditions. When conservative treatment is not effective, prophylactic surgery may be indicated to prevent more serious complications, such as irreversible bowel obstruction. Objective: To evaluate the clinical repercussions of mesenteric fibrosis and discuss the indications for prophylactic surgery in patients diagnosed with this condition. Methodology: The review was conducted based on the PRISMA checklist, searching for articles published in the last 10 years in the PubMed, Scielo and Web of Science databases. The descriptors "mesenteric fibrosis", "bowel obstruction", "prophylactic surgery", "mesenteric sclerosis" and "inflammatory bowel diseases" were used for the search. The inclusion criteria were: clinical and experimental studies addressing mesenteric fibrosis; articles published in English, Portuguese or Spanish; studies mentioning the prophylactic surgical approach. The exclusion criteria were: studies focusing on other gastrointestinal conditions not related to mesenteric fibrosis; articles that did not present relevant clinical data; non-original literature reviews. Results: The review revealed that mesenteric fibrosis is associated with significant clinical symptoms, such as chronic abdominal pain, abdominal distension and episodes of bowel obstruction. Prophylactic surgical intervention was indicated mainly for patients with progressive complications, such as irreversible intestinal obstruction and pain refractory to conservative treatment. Conclusion: Mesenteric fibrosis represents a considerable clinical challenge, with the potential to evolve into serious complications if not adequately treated. Prophylactic surgery is an important strategy in selected cases, especially when there is a risk of permanent intestinal obstruction. Early diagnosis and continuous monitoring are crucial for effective management of the disease, preventing major complications and improving the quality of life of patients.