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Creeping fat in Crohn’s disease: travelling in a creeper lane of research?
  1. A Schäffler,
  2. H Herfarth
  1. Department of Internal Medicine I, University of Regensburg, Regensburg, Germany
  1. Correspondence to:
    Dr A Schäffler
    Department of Internal Medicine I, University of Regensburg, D-93042 Regensburg, Germany; andreas.schaeffler{at}klinik.uni-regensburg.de

https://doi.org/10.1136/gut.2004.061531

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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.

    DR BURRIL B CROHN AND THE CREEPING FAT

    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 sporadically2–5 and it seems to have fallen into oblivion.6

    WHY DOES ADIPOSE TISSUE MATTER?

    Adipose tissue has long been regarded as a passive type of connective tissue that stores energy as triglycerides and releases energy as free fatty acids. However, due to the wide variety of hormones, proteins, peptides, complement factors, cytokines, enzymes, and receptors expressed in and secreted by adipocytes, the total adipose …

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    Footnotes

    • Conflict of interest: None declared.

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