-
African Journal of Paediatric Surgery :... 2022Mesenteric cysts are rare intra-abdominal masses and high index of suspicion is required to clinically suspect this pathology and make a definitive diagnosis. They are...
BACKGROUND
Mesenteric cysts are rare intra-abdominal masses and high index of suspicion is required to clinically suspect this pathology and make a definitive diagnosis. They are most commonly located in the ileal mesentery but can be located anywhere along the gastrointestinal tract mesentery and may extend into the retroperitoneum. The rarity of these anomalies and diversity of clinical picture pose challenges in the diagnosis and operative management. The objective of this study is to determine the demographic pattern, clinicopathological diagnosis and management outcome of mesenteric cysts in our hospital.
MATERIALS AND METHODS
This retrospective study was conducted on children operated for mesenteric cysts from October 2013 to September 2020. Statistical analysis was performed using Open Epi Version 3.01.
RESULTS
Out of 32 children with a diagnosis of mesenteric cyst, 78% were below 5 years of age. Small intestine was affected in 26 cases and large bowel mesentery was the site of origin in six cases. Complete excision of mesenteric cyst was possible in all cases. Bowel resection was required in ten cases (31%) to enable complete excision. Bowel resection was required more often in children operated on emergency than those with elective surgery, and is statistically significant (P = 0.04; confidence interval: 0.05-0.96, odds ratio: 0.23). An uncommon co-existence with ileal atresia and detection of rare chylolymphatic cyst in another infant were also remarkable findings. Histopathology proved the diagnosis in all cases. There was no mortality or recurrence during hospitalisation and follow-up, which ranged from 3 months to 3 years.
CONCLUSIONS
Mesenteric cysts present with diverse clinical features and children below 5 years of age are most commonly affected. Complete surgical excision is the optimal treatment and may require bowel resection in significant number of cases, especially those operated during emergency. Histopathology is the gold standard for diagnosis.
Topics: Abdomen; Child; Cysts; Humans; Infant; Mesenteric Cyst; Mesentery; Retrospective Studies
PubMed: 34916349
DOI: 10.4103/ajps.AJPS_158_20 -
Journal of Postgraduate Medicine 2018Extramedullary plasmacytoma represents 3%-5% of all plasma cell neoplasms. Plasmacytomas of the mesentery are extremely rare. We report the case of a 56-year-old man who...
Extramedullary plasmacytoma represents 3%-5% of all plasma cell neoplasms. Plasmacytomas of the mesentery are extremely rare. We report the case of a 56-year-old man who presented with an abdominal mass and was diagnosed to have plasmacytoma of the mesentery. A literature review was also conducted on publications pertaining to solitary mesenteric plasmacytomas. These patients present late by which time the abdominal mass has reached a significant size. Radiation as a modality for local control has a limited role in treating mesenteric plasmacytomas. Surgery is the preferred modality for local control. Patients must be kept on a regular follow-up as there is a risk of transformation to multiple myeloma.
Topics: Humans; Male; Mesentery; Middle Aged; Peritoneal Neoplasms; Plasmacytoma
PubMed: 30207325
DOI: 10.4103/jpgm.JPGM_296_18 -
Korean Journal of Radiology May 2023Diagnosing bowel and mesenteric trauma poses a significant challenge to radiologists. Although these injuries are relatively rare, immediate laparotomy may be indicated... (Review)
Review
Diagnosing bowel and mesenteric trauma poses a significant challenge to radiologists. Although these injuries are relatively rare, immediate laparotomy may be indicated when they occur. Delayed diagnosis and treatment are associated with increased morbidity and mortality; therefore, timely and accurate management is essential. Additionally, employing strategies to differentiate between major injuries requiring surgical intervention and minor injuries considered manageable via non-operative management is important. Bowel and mesenteric injuries are among the most frequently overlooked injuries on trauma abdominal computed tomography (CT), with up to 40% of confirmed surgical bowel and mesenteric injuries not reported prior to operative treatment. This high percentage of falsely negative preoperative diagnoses may be due to several factors, including the relative rarity of these injuries, subtle and non-specific appearances on CT, and limited awareness of the injuries among radiologists. To improve the awareness and diagnosis of bowel and mesenteric injuries, this article provides an overview of the injuries most often encountered, imaging evaluation, CT appearances, and diagnostic pearls and pitfalls. Enhanced diagnostic imaging awareness will improve the preoperative diagnostic yield, which will save time, money, and lives.
Topics: Humans; Wounds, Nonpenetrating; Abdominal Injuries; Intestines; Mesentery; Tomography, X-Ray Computed; Retrospective Studies
PubMed: 37133211
DOI: 10.3348/kjr.2022.0998 -
Journal of Gastrointestinal and Liver... Jun 2023A 67-year-old man with previous cardiovascular disease was referred to our consultation due to a 5-month history of recurrent epigastric pain. Esophagogastroduodenoscopy...
A 67-year-old man with previous cardiovascular disease was referred to our consultation due to a 5-month history of recurrent epigastric pain. Esophagogastroduodenoscopy and full blood workup presented no alterations. CT scan showed an irregularly shaped mass at the root of the mesentery, measuring 40x25x47mm, with spiculated contours and retractile behaviour (a). Simultaneous densification of the adjacent fat and infracentimetric ganglionic formations scattered throughout the mesentery were shown. Surgical biopsy revealed extensive storiform fibrosclerosis, with the presence of interstitial lymphoplasmocytic infiltrate and obliterative phlebitis (b); the plasma cells had mostly IgG expression, with IgG4:IgG ratio >40% (c), accounting for more than 30- 40 IgG4 plasma cells per field. The serum IgG4 level was 137mg/dL. A diagnosis of IgG4-related sclerosing mesenteritis was made, without other organ involvement. Prednisolone (0.6mg/kg/d) improved partially the abdominal pain, so steroid sparing strategy with off-label rituximab was associated. Due to its low prevalence, the understanding of this entity is scarce, and its diagnosis is challenging. Unlike other manifestations of IgG4-related disease, the intra-abdominal disease is identified in later stages, due to unspecific symptoms. This case aims to raise awareness about this condition as a differential diagnosis of abdominal pain.
Topics: Male; Humans; Aged; Panniculitis, Peritoneal; Immunoglobulin G; Prednisolone; Abdominal Pain; Mesentery
PubMed: 37345601
DOI: 10.15403/jgld-4921 -
Ultrasound in Medicine & Biology Nov 2020We tested the effect of low-frequency ultrasound (LUS, 20 kHz, 4 W/cm) on the function of rat mesentery and human pulmonary arteries with wire myography. The vessels...
We tested the effect of low-frequency ultrasound (LUS, 20 kHz, 4 W/cm) on the function of rat mesentery and human pulmonary arteries with wire myography. The vessels were induced to contract with either noradrenaline or physiologic saline solution (PSS) with a high potassium concentration (KPSS) and then incubated with capsaicin (2.1 × 10 M, TRPV1 [transient receptor potential vanilloid 1] activator), dopamine (1 × 10 M, dopamine and α-receptor activator), or fenoldopam (dopamine receptor agonist, 1 × 10 M) with and without glibenclamide (1 μM, KATP [adenosine triphosphate {sensitive potassium channel (ATP)}-sensitive potassium channel] inhibitor and α-receptor modulator), and insonated. Vessels were incubated in Ca-free PSS and induced to contract with added extracellular Ca and noradrenaline. Pulmonary arteries were induced to contract with KPSS and dopamine. Then the vessels were insonated. LUS inhibited the influx of external Ca, inhibited the dopamine-induced vasoconstriction in the KPSS (glibenclamide reversible), reduced the capsaicin-induced vasorelaxation, increased the gentamicin-induced vasorelaxation and increased the dopamine-induced contraction in the KPSS in human pulmonary arteries.
Topics: Animals; Humans; Mesentery; Myography; Pulmonary Artery; Rats; Rats, Wistar; Ultrasonic Waves
PubMed: 32768323
DOI: 10.1016/j.ultrasmedbio.2020.07.002 -
World Journal of Gastroenterology Jan 2018Primary benign schwannoma of the mesentery is extremely rare. To date, only 9 cases have been reported in the English literature, while mesenteric schwannoma with... (Review)
Review
Primary benign schwannoma of the mesentery is extremely rare. To date, only 9 cases have been reported in the English literature, while mesenteric schwannoma with ossified degeneration has not been reported thus far. In the present study, we present the first giant ossified benign mesenteric schwannoma in a 58-year-old female. Ultrasound, computed tomography and magnetic resonance imaging were used, but it was still difficult to determine the definitive location and diagnose the mass. By laparotomy, a 10.0 cm × 9.0 cm × 9.0 cm giant mass was found in the mesentery and was then completely resected. Microscopically, the tumour located in the mesentery mainly consisted of spindle-shaped cells with a palisading arrangement. Some areas of the tumour were ossified, and a true metaplastic bone formation was observed, with the presence of bone lamellae and osteoblasts. Immunohistochemical investigation of the tumour located in the mesentery showed that the staining for the S-100 protein was strongly positive, while the stainings of SMA, CD34, CD117 and DOG-1 were negative. The cell proliferation index, measured with Ki67 staining, was less than 3%. Finally, a giant ossified benign mesenteric schwannoma was diagnosed. After surgery, the patient was followed up for a period of 43 mo, during which she remained well, with no evidence of tumour recurrence.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy; Female; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Mesentery; Middle Aged; Neurilemmoma; Ossification, Heterotopic; Peritoneal Neoplasms; Tomography, X-Ray Computed; Treatment Outcome; Tumor Burden; Ultrasonography
PubMed: 29375216
DOI: 10.3748/wjg.v24.i2.303 -
World Journal of Surgical Oncology Feb 2023Laparoscopic and robotic surgery for transverse colon cancer are difficult due to complex fusion of the foregut and midgut and variation of the vessels of the transverse...
BACKGROUND
Laparoscopic and robotic surgery for transverse colon cancer are difficult due to complex fusion of the foregut and midgut and variation of the vessels of the transverse colon. Although the vessels of the right colon have been investigated, middle colic artery (MCA) variation and the relationship with vessels around the transvers colon are unknown. We investigated variation of the MCA using computed tomography angiography (CTA) and cadaver specimen and the relationship between the superior mesenteric vein (SMV) and MCA using CTA. The classification of vessels around the transverse colon may lead to safer and reliable surgery.
METHODS
This study included 505 consecutive patients who underwent CTA in our institution from 2014 to 2020 and 44 cadaver specimens. Vascular anatomical classifications and relationships were analyzed using CT images.
RESULTS
The MCA was defined as the arteries arising from the superior mesenteric artery (SMA) that flowed into the transverse colon at the distal ends. The classifications were as follows: type I, branching right and left from common trunk; type II, the right and left branches bifurcated separately from the SMA; and type III, the MCA branched from a vessel other than the SMA. Type II was subclassified into two subtypes, type IIa with one left branch and type IIb with two or more left branches from SMA. In the CTA and cadaver studies, respectively, the classifications were as follows: type I, n = 290 and n = 31; type IIa, n = 211 and n = 13; type IIb, n = 3 and n = 0; and type III, n = 1 and n = 0. We classified the relationship between the MCA and left side of the SMV into three types: type A, a common trunk runs along the left edge of the SMV (n = 173; 59.7%); type B, a right branch of the MCA runs along the left edge of the SMV (n = 116; 40.0%); and type C, the MCA runs dorsal of the SMV (n = 1; 0.3%).
CONCLUSIONS
This study revealed that The MCA branching classifications and relationship between the SMV and MCA. Preoperative CT angiography may be able to reliably identify vessel variation, which may be useful in clinical practice.
Topics: Humans; Colon, Transverse; Computed Tomography Angiography; Colon; Colonic Neoplasms; Mesentery; Laparoscopy; Cadaver
PubMed: 36747176
DOI: 10.1186/s12957-023-02919-9 -
Scientific Reports Oct 2019Galectin-3 (Gal-3) controls intercellular and cell-extracellular matrix interactions during immunological responses. In chronic inflammation, Gal-3 is associated with...
Galectin-3 (Gal-3) controls intercellular and cell-extracellular matrix interactions during immunological responses. In chronic inflammation, Gal-3 is associated with fibrotic events, regulates B cell differentiation and delays lupus progression. Gal-3 deficient mice (Lgals3) have intense germinal center formation and atypical plasma cell generation correlated to high levels IgG, IgE, and IgA. Here, we used pristane (2,6,10,14-tetramethylpentadecane) to induce lupus-like syndrome in Lgals3 and Lgals3 BALB/c mice. Mesentery and peritoneal cells were monitored because promptly react to pristane injected in the peritoneal cavity. For the first time, mesenteric tissues have been associated to the pathogenesis of experimental lupus-like syndrome. In Lgals3 pristane-induced mice, mesentery was hallmarked by intense fibrogranulomatous reaction restricted to submesothelial regions and organized niches containing macrophages and B lymphocytes and plasma cells. In contrast, Lgals3 pristane-treated mice had diffuse mesenteric fibrosis affecting submesothelium and peripheral tissues, atypical M1/M2 macrophage polarization and significant DLL1 cells expansion, suggesting possible involvement of Notch/Delta pathways in the disease. Early inflammatory reaction to pristane was characterized by significant disturbances on monocyte recruitment, macrophage differentiation and dendritic cell (DC) responses in the peritoneal cavity of pristane-induced Lgals3 mice. A correlative analysis showed that mesenteric damages in the absence of Gal-3 were directly associated with severe portal inflammation and hepatitis. In conclusion, it has suggested that Gal-3 orchestrates histological organization in the mesentery and prevents lupoid hepatitis in experimental lupus-like syndrome by controlling macrophage polarization, Notch signaling pathways and DC differentiation in mesenteric structures.
Topics: Animals; Disease Models, Animal; Female; Fibrosis; Galectin 3; Hepatitis; Humans; Injections, Intraperitoneal; Liver; Lupus Erythematosus, Systemic; Macrophages, Peritoneal; Mesentery; Mice; Mice, Knockout; Terpenes
PubMed: 31601823
DOI: 10.1038/s41598-019-50564-8 -
Journal of Cellular and Molecular... Oct 2022Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal intestinal tract and has characteristic hypertrophic adipose changes observed in the...
Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal intestinal tract and has characteristic hypertrophic adipose changes observed in the mesentery. To better understand the role of the mesentery in the pathophysiology of Crohn's disease (CD), we evaluated the immunomodulatory potential of mesenchymal stem cells (MSCs) and their secreted extracellular vesicles (EVs) derived from Crohn's patients. MSCs and EVs were isolated from the mesentery and subcutaneous tissues of CD patients and healthy individuals subcutaneous tissues, and were analysed for differentiation, cytokine expression, self-renewal and proliferation. The varying capacity of these tissue-derived MSCs and EVs to attenuate T-cell activation was measured in in vitro and an in vivo murine model. RNA sequencing of inflamed Crohn's disease mesentery tissue revealed an enrichment of T-cell activation compared to non-inflamed subcutaneous tissue. MSCs and MSC-derived EVs isolated from Crohn's mesentery lose their ability to attenuate DSS-induced colitis compared to subcutaneous tissue-derived cell or EV therapy. We found that treatment with subcutaneous isolated MSCs and their EV product compared to Crohn's mesentery MSCs or EVs, the inhibition of T-cell proliferation and IFN-γ, IL-17a production increased, suggesting a non-inflamed microenvironment allows for T-cell inhibition by MSCs/EVs. Our results demonstrate that Crohn's patient-derived diseased mesentery tissue MSCs lose their immunosuppressive capacity in the treatment of colitis by distinct regulation of pathogenic T-cell responses and/or T-cell infiltration into the colon.
Topics: Animals; Colitis; Crohn Disease; Cytokines; Extracellular Vesicles; Humans; Interleukin-17; Mesenchymal Stem Cells; Mesentery; Mice; T-Lymphocytes
PubMed: 36047483
DOI: 10.1111/jcmm.17483 -
World Journal of Gastroenterology Jan 2007Using animal mesentery with intravital optical microscopy is a well-established experimental model for studying blood and lymph microcirculation in vivo. Recent advances... (Review)
Review
Using animal mesentery with intravital optical microscopy is a well-established experimental model for studying blood and lymph microcirculation in vivo. Recent advances in cell biology and optical techniques provide the basis for extending this model for new applications, which should generate significantly improved experimental data. This review summarizes the achievements in this specific area, including in vivo label-free blood and lymph photothermal flow cytometry, super-sensitive fluorescence image cytometry, light scattering and speckle flow cytometry, microvessel dynamic microscopy, infrared (IR) angiography, and high-speed imaging of individual cells in fast flow. The capabilities of these techniques, using the rat mesentery model, were demonstrated in various studies; e.g., real-time quantitative detection of circulating and migrating individual blood and cancer cells, studies on vascular dynamics with a focus on lymphatics under normal conditions and under different interventions (e.g. lasers, drugs, nicotine), assessment of lymphatic disturbances from experimental lymphedema, monitoring cell traffic between blood and lymph systems, and high-speed imaging of cell transient deformability in flow. In particular, the obtained results demonstrated that individual cell transportation in living organisms depends on cell type (e.g., normal blood or leukemic cells), the cellos functional state (e.g., live, apoptotic, or necrotic), and the functional status of the organism. Possible future applications, including in vivo early diagnosis and prevention of disease, monitoring immune response and apoptosis, chemo- and radio-sensitivity tests, and drug screening, are also discussed.
Topics: Animals; Blood Cells; Blood Circulation; Drug Evaluation, Preclinical; Flow Cytometry; Lymphatic System; Mesentery; Microscopy; Models, Animal; Rats
PubMed: 17226898
DOI: 10.3748/wjg.v13.i2.192