Abstract
Mesenteric panniculitis is a chronic disorder that belongs to a spectrum of rare diseases or tumor-like lesions that thickens and shortens the mesentery. There is no direct cause for mesenteric panniculitis, but it may be precipitated by some conditions such as malignancy, previous abdominal surgery, and infections. It has a male predominance with a 0.6% prevalence and a positive correlation with an increase in age. Mesenteric panniculitis has various stages depending on the pathological change present. The stage of mesenteric panniculitis governs the manifestations presented on the patient. However, it is often silent with no symptoms. 30-50% of patients will remain asymptomatic throughout the course of the disease and require no treatment, as the indication of treatment is developing symptoms. A computed tomography scan is the most sensitive method for the diagnosis of mesenteric panniculitis. On the other hand, histopathology is the most specific. Out of all the reported cases, this is the youngest Saudi male that presented with idiopathic mesenteric panniculitis. A 25 year-old male presented to the emergency department with abdominal pain for two days. At presentation, he was on severe abdominal pain, afebrile, hemodynamically stable apart from mild tachycardia. Abdominal examination revealed significant tenderness at the epigastric and left upper abdomen. The patient was admitted and treated accordingly. We hope this case could demonstrate the importance of careful assessment by the treating physician. Further studies about the most suitable treating regimen in such conditions of mesenteric panniculitis are needed, as it carries a risk for neoplastic changes.

Key words: Mesenteric panniculitis, Abdominal pain, Saudi Arabia