肠系膜脓肿是一种罕见的腹部感染，通常主要继发于炎症性肠病、小肠憩室或结核。原发性肠系膜脓肿极为罕见。如果不及时诊断和治疗，可能会导致严重的后果；计算机断层扫描对于这种疾病的诊断非常有益；及时的手术干预、明智地使用抗生素和充足的营养支持对于治疗这种疾病至关重要。一名来自中国的59岁男性患者因间歇性腹痛伴食欲不振10天入院。入院前1周，患者曾感染2019冠状病毒病，既往病史包括2型糖尿病和术后胃癌。患者急诊腹部计算机断层扫描结果提示肠系膜混浊，有大量异物。渗出液和可见气泡。考虑是肠系膜脓肿，但不能排除十二指肠穿孔，我们采取剖腹探查进一步明确诊断。术中，充分暴露十二指肠后，发现肠系膜广泛脓肿形成，但未发现十二指肠穿孔。术后患者出现十二指肠漏，给予胃管和空肠营养管治疗。术后，患者因全身状况不佳，转入重症监护室；经抗感染治疗，术后第5天病情好转，术后第9天出现十二指肠漏，保守治疗无效，患者最终死亡。 原发性肠系膜脓肿是一种局部组织感染性疾病。而治疗过程中要考虑患者的身体基本状况。我们相信，充分的术后引流、基于细菌培养合理使用抗生素、术后早期下床活动以及充足的营养支持可能是成功治疗的关键点。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 出版

Mesenteric abscess, a rare abdominal infection, is regularly mostly secondary to inflammatory bowel disease, diverticula of the small intestine, or tuberculosis. Primary mesenteric abscesses are extremely rare. If not diagnosed and treated in a timely manner, it may lead to serious consequences; computerized tomography is highly beneficial for the diagnosis of this disease; timely surgical intervention, judicious use of antibiotics, and adequate nutritional support are crucial in the management of this disease.A 59-year-old male patient from China was admitted to hospital for intermittent abdominal pain accompanied by poor appetite for 10 days. One week before admission, the patient had been infected with corona virus disease 2019. Past history includes type 2 diabetes and post-operative gastric cancer.The emergency abdominal computerized tomography examination results of the patient suggested that the mesentery was cloudy with a large amount of effusion and visible bubble. Mesentery abscess was considered, but duodenal perforation could not be excluded.We adopted exploratory laparotomy to further clarify the diagnosis. Intraoperatically, after fully exposing the duodenum, we found extensive abscess formation in the mesentery, but no duodenal perforation. After operation, the patient developed duodenal leakage and was treated with gastric tube and jejunal nutrition tube.Postoperatively, due to poor general condition, the patient was transferred to intensive care unit; after anti-infective treatment, the condition improved on the 5th postoperative day, and duodenal leakage appeared on the 9th postoperative day, and conservative treatment was ineffective, and the patient eventually died.Primary mesenteric abscess is a local tissue infectious disease. Whereas we should consider the physical basic condition of the patient during therapeutic process. We believe adequate postoperative drainage, rational use of antibiotics based on bacterial culture, early ambulation after surgery, and adequate nutritional support might be key points for successful therapy.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.