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The American Journal of Gastroenterology Jan 2020Disorders of the mesenteric, portal, and hepatic veins and mesenteric and hepatic arteries have important clinical consequences and may lead to acute liver failure,... (Review)
Review
Disorders of the mesenteric, portal, and hepatic veins and mesenteric and hepatic arteries have important clinical consequences and may lead to acute liver failure, chronic liver disease, noncirrhotic portal hypertension, cirrhosis, and hepatocellular carcinoma. Although literature in the field of vascular liver disorders is scant, these disorders are common in clinical practice, and general practitioners, gastroenterologists, and hepatologists may benefit from expert guidance and recommendations for management of these conditions. These guidelines represent the official practice recommendations of the American College of Gastroenterology. Key concept statements based on author expert opinion and review of literature and specific recommendations based on PICO/GRADE analysis have been developed to aid in the management of vascular liver disorders. These recommendations and guidelines should be tailored to individual patients and circumstances in routine clinical practice.
Topics: Gastroenterology; Humans; Liver; Liver Circulation; Liver Diseases; Mesentery; Practice Guidelines as Topic; Societies, Medical; Splanchnic Circulation; United States; Vascular Diseases
PubMed: 31895720
DOI: 10.14309/ajg.0000000000000486 -
Digestive Diseases and Sciences Mar 2022Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the... (Review)
Review
Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the gastrointestinal tract from the duodenum to the rectum. The clinical condition is entirely asymptomatic in many patients, particularly with small cysts. The diagnosis is typically incidental and secondary to imaging performed for other purposes. In symptomatic patients, the clinical picture is characterized by nonspecific gastrointestinal signs and symptoms. Treatment may be surgical or via interventional radiology. We report the case of a 55-year-old female patient complaining of left-sided abdominal discomfort and constipation lasting three months. An abdominal ultrasound showed the presence of a 10 × 14 × 16 cm anechoic cystic mass filling the whole anterior and left abdominal cavity, confirmed by CT and MRI. The cyst, removed laparoscopically, was histologically a simple mesothelial cyst. We reviewed the international literature over the last 10 years of all cases with mesenteric cysts > 10 cm in evaluating gastrointestinal symptoms at diagnosis, histology, performed treatment, and outcome.
Topics: Cysts; Female; Humans; Magnetic Resonance Imaging; Mesenteric Cyst; Mesentery; Middle Aged; Ultrasonography
PubMed: 35059952
DOI: 10.1007/s10620-021-07352-0 -
Revista Espanola de Enfermedades... Apr 2023Gastrointestinal tuberculosis (TB) is a rare disease and only involves the duodenum in 2-2,5% of all cases. A 60-year-old female with no reported medical history,...
Gastrointestinal tuberculosis (TB) is a rare disease and only involves the duodenum in 2-2,5% of all cases. A 60-year-old female with no reported medical history, presented with constitutional syndrome with a 10 kg weight loss in three months, epigastric pain, bloating and vomiting. She denied fever or respiratory symptoms. Laboratory examination revealed elevated C-reactive protein levels and low prealbumin. Abdominal computed tomography (CT) showed duodenal wall thickening, mainly in its third part, with infiltration of the root of the mesentery and numerous subcentimeter adenopathies at that level.
Topics: Female; Humans; Middle Aged; Duodenum; Abdomen; Abdominal Pain; Mesentery; Tuberculosis, Gastrointestinal
PubMed: 36695766
DOI: 10.17235/reed.2023.9373/2022 -
Colorectal Disease : the Official... Jan 2021Recurrence after surgery for Crohn's disease is common. Anastomotic configuration may influence recurrence and the mesentery may be key. Recently the Kono-S anastomosis... (Review)
Review
AIM
Recurrence after surgery for Crohn's disease is common. Anastomotic configuration may influence recurrence and the mesentery may be key. Recently the Kono-S anastomosis and radical mesenteric excision have been proposed as methods of reducing recurrence. We analysed the literature pertaining to these novel techniques.
METHOD
We searched MEDLINE, Embase and the Cochrane Library for, and selected, studies evaluating Kono-S anastomosis and/or radical mesenteric excision in Crohn's disease. We assessed methodological quality and risk of bias using the Cochrane risk of bias tool for randomized controlled trials and the Joanna Briggs Institute tool for nonrandomized trials. A narrative synthesis was used to summarize the findings.
RESULTS
Nine studies (896 patients) were identified. Apart from one randomized controlled trial with a low risk of bias the overall level of evidence was poor (Grade IV). The Kono-S anastomosis was associated with a lower incidence of endoscopic and surgical recurrence (0%-3.4% vs 15%-24.4% respectively). Complications, particularly anastomotic leak rate, were also lower (1.8% vs 9.3% respectively). Evidence from a single poor quality study suggested that mesenteric excision may reduce surgical recurrence rates compared with mesentery preservation.
CONCLUSION
The existing literature suggests that the Kono-S anastomosis is safe and may reduce endoscopic and surgical recurrence, but level of evidence is mainly poor. One element of the Kono-S technique, preservation of the mesentery, may be detrimental to recurrence. Further, higher quality, studies are required to investigate these techniques. Such studies should consider the impact of the degree of mesenteric resection in addition to the anastomosis on disease recurrence.
Topics: Anastomosis, Surgical; Anastomotic Leak; Crohn Disease; Humans; Ileum; Mesentery; Randomized Controlled Trials as Topic; Recurrence
PubMed: 32418300
DOI: 10.1111/codi.15136 -
Seminars in Cell & Developmental Biology Aug 2019
Topics: Mesentery; Organogenesis
PubMed: 30336281
DOI: 10.1016/j.semcdb.2018.10.006 -
Saudi Journal of Kidney Diseases and... 2022Lymphangiomatosis is a rare and benign mesenchymal disorder where there is developmental malformation and dilatation of lymphatic channels. The most common sites for...
Lymphangiomatosis is a rare and benign mesenchymal disorder where there is developmental malformation and dilatation of lymphatic channels. The most common sites for lymphangiomatosis are the cervical neck and axilla, but it can also occur in the mediastinum, retroperitoneum, mesentery, omentum, colon, and pelvis. Renal lymphangiomatosis is an even rarer multicystic disorder which may be hilar, pericalyceal, paracalyceal, peripelvic, or para pelvic. We report a case of 24-year-old female with bilateral perirenal lymphangiomatosis. Her complain was bilateral flank pain and bilateral perinephric fluid collection with multiple sepatations was noted on radiological examination.
Topics: Humans; Female; Young Adult; Adult; Lymphangioma; Kidney; Kidney Diseases; Mesentery; Thorax
PubMed: 36647995
DOI: 10.4103/1319-2442.367815 -
RoFo : Fortschritte Auf Dem Gebiete Der... Jul 2022
Topics: Adenomatous Polyposis Coli; Fibromatosis, Aggressive; Humans; Mesentery; Retroperitoneal Neoplasms
PubMed: 35613911
DOI: 10.1055/a-1814-3819 -
Seminars in Cell & Developmental Biology Aug 2019The mesentery, a newly minted organ, plays various anatomical and physiological roles during animal development. In echinoderms, and particularly in members of the class... (Review)
Review
The mesentery, a newly minted organ, plays various anatomical and physiological roles during animal development. In echinoderms, and particularly in members of the class Holothuroidea (sea cucumbers) the mesentery plays an additional unique role: it is crucial for the process of intestinal regeneration. In these organisms, a complete intestine can form from cells that originate in the mesentery. In this review, we focus on what is known about the changes that take place in the mesentery and what has been documented on the cellular and molecular mechanisms involved. We describe how the events that unfold in the mesentery result in the formation of a new intestine.
Topics: Animals; Humans; Intestines; Mesentery; Regeneration; Sea Cucumbers
PubMed: 30193995
DOI: 10.1016/j.semcdb.2018.09.001 -
Emerging Topics in Life Sciences Sep 2020The mesentery is the organ in which all abdominal digestive organs develop, and which maintains these in systemic continuity in adulthood. Interest in the mesentery was... (Review)
Review
The mesentery is the organ in which all abdominal digestive organs develop, and which maintains these in systemic continuity in adulthood. Interest in the mesentery was rekindled by advancements of Heald and Hohenberger in colorectal surgery. Conventional descriptions hold there are multiple mesenteries centrally connected to the posterior midline. Recent advances first demonstrated that, distal to the duodenojejunal flexure, the mesentery is a continuous collection of tissues. This observation explained how the small and large intestines are centrally connected, and the anatomy of the associated peritoneal landscape. In turn it prompted recategorisation of the mesentery as an organ. Subsequent work demonstrated the mesentery remains continuous throughout development, and that abdominal digestive organs (i.e. liver, spleen, intestine and pancreas) develop either on, or in it. This relationship is retained into adulthood when abdominal digestive organs are directly connected to the mesentery (i.e. they are 'mesenteric' in embryological origin and anatomical position). Recognition of mesenteric continuity identified the mesenteric model of abdominal anatomy according to which all abdominal abdomino-pelvic organs are organised into either a mesenteric or a non-mesenteric domain. This model explains the positional anatomy of all abdominal digestive organs, and associated vasculature. Moreover, it explains the peritoneal landscape and enables differentiation of peritoneum from the mesentery. Increased scientific focus on the mesentery has identified multiple vital or specialised functions. These vary across time and in anatomical location. The following review demonstrates how recent advances related to the mesentery are re-orientating the study of human biology in general and, by extension, clinical practice.
Topics: Animals; Digestive System; Duodenum; Embryonic Development; Humans; Mesentery; Peritoneum; Tomography, X-Ray Computed
PubMed: 32539112
DOI: 10.1042/ETLS20200006 -
QJM : Monthly Journal of the... Mar 2024
Topics: Humans; Panniculitis, Peritoneal; Mesentery
PubMed: 38039181
DOI: 10.1093/qjmed/hcad266