Update on the mesentery: structure, function, and role in disease

Coffey, J. Calvin; Byrnes, Kevin Gerard; Walsh, Dara; Cunningham, Robert

doi:10.1016/s2468-1253(21)00179-5

Cited by 24 publications

(25 citation statements)

References 60 publications

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“…Recent studies have highlighted the interconnection of mesentery with other abdominal organs. 33 In a retrospective study, it was shown that mesenteric resection substantially reduced POR rates (40% to 3%). 2 However, block resection and mesenteric inclusion surgeries were performed at different points in the time frame leading to variation in flow up time and postoperative prophylactic therapy which could influence the results of the aforementioned study.…”

Section: Mesenteric Involvement (M)mentioning

confidence: 98%

“…Mesenteric adipose tissue migrates to the site of intestinal inflammation in CD which leads to the fat wrapping of the inflamed intestine. Recent studies have highlighted the interconnection of mesentery with other abdominal organs [ 33 ]. In a retrospective study, it was shown that mesenteric resection substantially reduced POR rates (40% to 3%) [ 2 ].…”

Section: Histological Predictors Of Por Of CDmentioning

confidence: 99%

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Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease

et al. 2023

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scopic/clinical/surgical recurrence. So, recurrence in postoperative CD is primarily "relapse" or "persistent CD" rather than true recurrence. Among the histological features predicting recurrence in postoperative CD, the most commonly studied factor is positive resection margins. Microscopic positive resection margin increases the risk of clinical, surgical, and early recurrence (<12 months) by 2-, 9-, and 6-fold, respectively (Table 1). 1 Similarly, a retrospective study has shown that the inclusion of mesentery at ileocolonic resection in CD reduces the surgical recurrence rate substantially (40% to 2.9%). 2 However, the study results are confounded by different follow-up times and concerns regarding a higher risk of postoperative complications due to vascular compromise. 3 Hence, this is currently studied in randomized controlled trials (RCTs). 4 My-

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Section: Mesenteric Involvement (M)mentioning

confidence: 98%

Section: Histological Predictors Of Por Of CDmentioning

confidence: 99%

Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease

et al. 2023

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“…On MRE, this presents as reduced signal intensity on T1-weighted images (see Figure 3 ) [ 11 ]. The presence of fibrofatty proliferation is pathognomonic for CD and is suggestive of longstanding disease [ 38 ]. Studies have demonstrated that creeping fat may indeed persist despite endoscopic response to therapy [ 17 , 39 ].…”

Section: Mre Parameters That Correlate With Disease Activitymentioning

confidence: 99%

Replacing Endoscopy with Magnetic Resonance Enterography for Mucosal Activity Assessment in Terminal Ileal Crohn’s Disease: Are We There Yet?

et al. 2023

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Crohn’s disease (CD) is a chronic immune mediated disorder that most commonly affects the small bowel and/or the large bowel. Treatment targets in CD include mucosal healing assessed via ileocolonoscopy and transmural healing assessed through cross-sectional imaging modalities such as magnetic resonance enterography (MRE). More recently, histological healing in CD has emerged as a treatment target, though it is made cumbersome given its reliance on frequent endoscopic examinations. With expert guidelines now recommending regular objective assessments as part of a treat-to-target approach, accurate non-invasive assessment will become increasingly critical. MRE has an established role in the assessment of small bowel CD, with growing data supportive of its ability in detecting disease activity at mucosal and histological levels. This could therefore potentially reduce the need for serial endoscopic assessment. Thus, this review will assess the capacity of individual MRE parameters and MRE indices for detecting mucosal and histological small bowel CD activity. Furthermore, challenging scenarios, such as CD activity detection in post-operative clinical scenarios and abnormal findings in the context of a normal ileocolonoscopy, will be explored.

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“…Our understanding of the anatomy of these regions has undergone substantial revision following formal characterization. [36][37][38] During development, the lower region of the mesentery is overlapped by the upper region of the mesentery. In adulthood a fascial layer occurs between adherent regions of upper and lower regions.…”

Section: Lower Region Developmentmentioning

confidence: 99%

“…This central position lends itself to being a key mediator for signals travelling between the abdominal digestive system and the rest of the body. 37…”

Section: Abdominal Digestive System Developmentmentioning

confidence: 99%

The Development of the Mesenteric Model of Abdominal Anatomy

Byrnes

Cullivan

Walsh

et al. 2022

Clin Colon Rectal Surg

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Recent advances in mesenteric anatomy have clarified the shape of the mesentery in adulthood. A key finding is the recognition of mesenteric continuity, which extends from the oesophagogastric junction to the mesorectal level. All abdominal digestive organs develop within, or on, the mesentery and in adulthood remain directly connected to the mesentery. Identification of mesenteric continuity has enabled division of the abdomen into two separate compartments. These are the mesenteric domain (upon which the abdominal digestive system is centered) and the non-mesenteric domain, which comprises the urogenital system, musculoskeletal frame, and great vessels. Given this anatomical endpoint differs significantly from conventional descriptions, a reappraisal of mesenteric developmental anatomy was recently performed. The following narrative review summarizes recent advances in abdominal embryology and mesenteric morphogenesis. It also examines the developmental basis for compartmentalizing the abdomen into two separate domains along mesenteric lines.

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Update on the mesentery: structure, function, and role in disease

Cited by 24 publications

References 60 publications

Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease

Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease

Replacing Endoscopy with Magnetic Resonance Enterography for Mucosal Activity Assessment in Terminal Ileal Crohn’s Disease: Are We There Yet?

The Development of the Mesenteric Model of Abdominal Anatomy

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