COMMENTARY

Crohn's disease

Creeping fat in Crohn’s disease: travelling in a creeper lane of research?

A Schäffler and H Herfarth

Department of Internal Medicine I, University of Regensburg, Regensburg, Germany

Correspondence to:
Correspondence to:
Dr A Schäffler
Department of Internal Medicine I, University of Regensburg, D-93042 Regensburg, Germany; andreas.schaeffler@klinik.uni-regensburg.de

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Identification of a distinct secretion pattern of adipocytokines from creeping fat in Crohn’s disease and from mesenteric adipose tissue in chronic inflammatory bowel diseases (IBD) or mesenteric diseases can be considered as work in progress. Characterisation of visceral adipose tissue by its highly active secretory products may lead to the discovery of specific discrimination and activity markers in IBD and may provide future targets for drug therapy. In addition, the cellular compartment of macrophages residing within the mesenteric adipose tissue is becoming recognised as bearing pathophysiological relevance.

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Keywords: Crohn’s disease; fat wrapping; mesenteric adipocytokines; adiponectin; adipose tissue; creeping fat

The first 150 words of the full text of this article appear below.

The connective and adipose tissue changes observed in patients with Crohn’s disease (CD) have received only little attention from pathologists, although fat hypertrophy, fat wrapping (fat creeping upon the bowel), and creeping fat have long been recognised by surgeons as a phenomenon suitable for delineating the extent of active disease. Dr Burril B Crohn himself, who gave his name to this chronic inflammatory bowel disease, initially described the changes in the appearance of the mesenteric adipose tissue as a characteristic symptom of the disease.¹ Sheehan and colleagues² and others³ defined fat wrapping as present if more than 50% of the intestinal surface is covered by adipose tissue. Fat encroachment of the antimesenteric surface of the bowel displays a characteristic feature of CD, leading to complete enveloping of the antimesenteric surface and obliteration of the bowel-mesentery angle.³

To date, the pathophysiology of creeping fat has been investigated only sporadically^2–5 . . . [Full text of this article]

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