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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 -
Drug Metabolism Reviews Aug 2018With the inclusion of mesentery, the total number of human organs has recently increased by one. The mesentery was formerly construed to be a complex, discontinuous... (Review)
Review
With the inclusion of mesentery, the total number of human organs has recently increased by one. The mesentery was formerly construed to be a complex, discontinuous anatomical structure simply serving as a support for organs in abdominal cavity. However, recent research has established the mesentery to be a far more simple and unfragmented organ. Newly emerging information on the mesentery has challenged some older pathophysiological concepts. This review briefly discusses the anatomy of the mesentery, historical perspective on the mesentery, embryology, drug metabolizing enzymes and transporters of the mesentery, and the mesentery's role in diseases. The possible impact of the mesentery on absorption, distribution, metabolism, and excretion (ADME) is also discussed.
Topics: Animals; Biological Transport, Active; Humans; Mesentery; Pharmaceutical Preparations; Pharmacokinetics
PubMed: 30009643
DOI: 10.1080/03602532.2018.1484756 -
The Lancet. Gastroenterology &... Jan 2022Over the past 5 years, systematic investigation of the mesenteric organ has expanded and shown that the mesentery is the organ in and on which all abdominal digestive... (Review)
Review
Over the past 5 years, systematic investigation of the mesenteric organ has expanded and shown that the mesentery is the organ in and on which all abdominal digestive organs develop and remain connected to. In turn, this observation has clarified the anatomical foundation of the abdomen and the fundamental order at that level. Findings related to the shape and development of the mesentery have illuminated its function, advancing our understanding of the pathobiology, diagnosis, and treatment of several abdominal and systemic diseases. Inclusion of the mesentery in surgical resections alters the course of benign and malignant diseases. Mesenteric-based scoring systems can enhance the radiological interpretation of abdominal disease. Emerging findings reconcile observations across scientific and clinical fields and have been assimilated into reference curricula and practice guidelines. This Review summarises the developmental, anatomical, and clinical advances made since the mesentery was redesignated as an organ in 2016.
Topics: Gastrointestinal Diseases; Gastrointestinal Tract; Humans; Lymphatic Metastasis; Mesentery
PubMed: 34822760
DOI: 10.1016/S2468-1253(21)00179-5 -
The Lancet. Gastroenterology &... Nov 2016Systematic study of the mesentery is now possible because of clarification of its structure. Although this area of science is in an early phase, important advances have... (Review)
Review
Systematic study of the mesentery is now possible because of clarification of its structure. Although this area of science is in an early phase, important advances have already been made and opportunities uncovered. For example, distinctive anatomical and functional features have been revealed that justify designation of the mesentery as an organ. Accordingly, the mesentery should be subjected to the same investigatory focus that is applied to other organs and systems. In this Review, we summarise the findings of scientific investigations of the mesentery so far and explore its role in human disease. We aim to provide a platform from which to direct future scientific investigation of the human mesentery in health and disease.
Topics: Humans; Mesentery; Peritoneal Diseases
PubMed: 28404096
DOI: 10.1016/S2468-1253(16)30026-7 -
Seminars in Cell & Developmental Biology Aug 2019Recent appraisals of mesenteric anatomy clarify its structure and show a continuous and helical-shaped organ. This new model signifies a departure from the conventional... (Review)
Review
Recent appraisals of mesenteric anatomy clarify its structure and show a continuous and helical-shaped organ. This new model signifies a departure from the conventional model which described multiple, separate "mesenteries". Renaissance anatomists depicted the mesentery as a continuous structure. Events that led to replacement of a continuous with a fragmented model span several centuries. In effect, the scientific and clinical community has come full circle and back to the Renaissance model. Here we review the historical development of our understanding of the mesentery. We discuss how the fragmented model replaced the continuous model. Additionally, we examine factors that contributed to recent advances in mesenteric anatomy as these present new opportunities for systematic investigation.
Topics: Humans; Mesentery
PubMed: 30316830
DOI: 10.1016/j.semcdb.2018.10.003 -
Communications Biology Aug 2021The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of...
The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of abdominal anatomy, there are multiple mesenteries. Recent findings point to an alternative model in which digestive organs are connected to a single mesentery. Given that direct evidence of this is currently lacking, we investigated the development and shape of the entire mesentery. Here we confirm that, within the abdomen, there is one mesentery in which all abdominal digestive organs develop and remain connected to. We show that all abdominopelvic organs are organised into two, discrete anatomical domains, the mesenteric and non-mesenteric domain. A similar organisation occurs across a range of animal species. The findings clarify the anatomical foundation of the abdomen; at the foundation level, the abdomen comprises a visceral (i.e. mesenteric) and somatic (i.e. musculoskeletal) frame. The organisation at that level is a fundamental order that explains the positional anatomy of all abdominopelvic organs, vasculature and peritoneum. Collectively, the findings provide a novel start point from which to systemically characterise the abdomen and its contents.
Topics: Humans; Mesentery; Peritoneum
PubMed: 34408242
DOI: 10.1038/s42003-021-02496-1 -
Pediatric Radiology Jul 2017The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g.,... (Review)
Review
The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g., fat) and structures (e.g., blood vessels and lymph nodes) contained within them. These structures become more visible and change in appearance when involved by pathological processes. In this pictorial essay, we discuss the normal anatomy of the various abdominopelvic peritoneal structures and illustrate numerous developmental and acquired diagnoses that involve these structures in the pediatric and young adult population.
Topics: Child; Humans; Mesentery; Omentum; Peritoneum
PubMed: 28646385
DOI: 10.1007/s00247-017-3864-3 -
Zhonghua Wei Chang Wai Ke Za Zhi =... Jul 2021The posterior gastric mesentery is one of the six mesenteries of the stomach in the membrane anatomy theory. It locates in the upper area of the pancreas, surrounds the...
The posterior gastric mesentery is one of the six mesenteries of the stomach in the membrane anatomy theory. It locates in the upper area of the pancreas, surrounds the posterior gastric vessels, and is adjacent to the short gastric mesentery by the left side, and is adjacent to the left gastric mesentery by the right side, which fixes the fundus body to the posterior abdominal wall of the upper area of pancreas. Due to its anatomical structure, in complete mesentery excision (CME)+D2 surgery, it is a surgical approach to deal with gastric mesentery in the upper area of pancreas; the second step of the "Huang's three-step method" corresponds to the posterior gastric mesentery in the theory of membrane anatomy. In the surgery of benign diseases of the stomach, laparoscopic sleeve gastrectomy (LSG) and laparoscopic Nissen fundoplication, if the short gastric vessels are difficult to be exposed and safely divided, we can dissect the posterior gastric mesentery firstly, and then hoist the fundus of the stomach in order to help dissection of the short gastric vessels. The membrane anatomy theory, as a frontier theory, provides us the new surgical perspectives and paths in gastric surgery.
Topics: Gastrectomy; Humans; Laparoscopy; Lymph Node Excision; Mesentery; Stomach Neoplasms
PubMed: 34289539
DOI: 10.3760/cma.j.cn.441530-20201212-00658 -
Revue Medicale de Nancy
Topics: Humans; Mesentery
PubMed: 12994437
DOI: No ID Found -
Abdominal Radiology (New York) Nov 2020Mesenteries are extensions of the visceral and parietal peritoneum consisting of fat, vessels, nerves, and lymphatics. Mesenteric masses have a wide differential... (Review)
Review
Mesenteries are extensions of the visceral and parietal peritoneum consisting of fat, vessels, nerves, and lymphatics. Mesenteric masses have a wide differential diagnosis with neoplastic, infectious, or inflammatory etiologies and can either be solid or cystic. Imaging features are critical for the diagnosis. We review the epidemiology, imaging spectrum, and differentiating features and treatment of mesenteric masses.
Topics: Diagnosis, Differential; Humans; Mesentery; Peritoneal Neoplasms; Peritoneum; Tomography, X-Ray Computed
PubMed: 32300835
DOI: 10.1007/s00261-020-02535-1