OVERVIEW
The mesentery is the peritoneum that suspends the intestines from the posterior abdominal wall. Mesenteric diseases are uncommon in clinical practice and are categorized according to the anatomic origin of the mesentery into small bowel mesenteric diseases, transverse colon mesenteric diseases, sigmoid colon mesenteric diseases, and appendiceal mesenteric diseases.
Causes
1. Mesenteric cysts: they can come from congenital developmental abnormalities, such as enterogenic cysts, colonic mesenteric plasma cysts, dermatoid cysts, etc.; they can also originate from cysts caused by trauma (hemorrhagic cysts, inflammatory cysts).
2. Secondary tumors of mesentery: most mesenteric tumors are metastatic tumors, gastric, intestinal, ovarian and peritoneal mesothelioma can be metastasized to mesentery through various ways, among which lymphatic metastasis and direct implantation metastasis are the main ones.
Symptoms
1. Mesenteric cyst
In the early stage, there is no symptom, but after the volume increases or bleeding or infection occurs in the capsule, there may be hidden pain or distension in the abdomen, and the patients can feel the swelling in the abdomen.
2. Primary tumor of mesentery
There is no special clinical symptom when the benign tumor is small, after the tumor increases, patients may consult the doctor because of vague pain in the abdomen and “mass” in the abdomen. Patients with malignant tumors may suffer from emaciation, anemia, and a few patients may show symptoms of intestinal obstruction.
3.Mesenteric secondary tumors
Clinical symptoms of primary tumors in other parts of the body are usually present. Tumors originated from gastrointestinal tract can present abdominal pain, blood in stool, change of bowel habit, intestinal obstruction and other symptoms; tumors originated from ovary can present lower abdominal pain, and some patients are found with abdominal distension and ascites. Most of them have systemic clinical manifestations such as emaciation and anemia.
Examination
1. X-ray barium meal may show that the intestinal tube is compressed and displaced.
2. Abdominal B-mode ultrasound, electronic computed tomography (CT) or magnetic resonance imaging (MRI): helps to locate and characterize.
Diagnosis
The diagnosis of mesenteric disease is mainly based on clinical manifestations, and laboratory tests and imaging tests assist in confirming the diagnosis.
Treatment
Surgical resection is the only treatment for mesenteric disease, either by extraction or partial resection. If necessary, part of the small intestine can be removed as well. If the resection is not complete, benign tumors may recur or become malignant. The radical resection rate of malignant tumors is low and the prognosis is not good. After surgery, chemotherapy or radiation therapy can be used according to the pathology of the tumor.