Journal articles: 'Mesenteric anatomy'

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Coffey, J. Calvin, Dara Walsh, Kevin G. Byrnes, Werner Hohenberger, and Richard J. Heald. "Mesentery — a ‘New’ organ." Emerging Topics in Life Sciences 4, no. 2 (June 15, 2020): 191–206. http://dx.doi.org/10.1042/etls20200006.

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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.

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O'Regan, Patrick W., Jennifer M. Ní Mhuircheartaigh, Timothy G. Scanlon, and Martin J. Shelly. "Radiology of the Mesentery." Clinics in Colon and Rectal Surgery 35, no. 04 (July 2022): 328–37. http://dx.doi.org/10.1055/s-0042-1744481.

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AbstractThe recent description and re-classification of the mesentery as an organ prompted renewed interest in its role in physiological and pathological processes. With an improved understanding of its anatomy, accurately and reliably assessing the mesentery with non-invasive radiological investigation becomes more feasible.Multi-detector computed tomography is the main radiological modality employed to assess the mesentery due to its speed, widespread availability, and diagnostic accuracy.Pathologies affecting the mesentery can be classified as primary or secondary mesenteropathies. Primary mesenteropathies originate in the mesentery and subsequently progress to involve other organ systems (e.g., mesenteric ischemia or mesenteric volvulus). Secondary mesenteropathies describe disease processes that originate elsewhere and progress to involve the mesentery with varying degrees of severity (e.g., lymphoma).The implementation of standardized radiological imaging protocols, nomenclature, and reporting format with regard to the mesentery will be essential in improving the assessment of mesenteric anatomy and various mesenteropathies.In this article, we describe and illustrate the current state of art in respect of the radiological assessment of the mesentery.

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Coffey, J. Calvin. "Future Directions." Clinics in Colon and Rectal Surgery 35, no. 04 (July 2022): 349–50. http://dx.doi.org/10.1055/s-0042-1743431.

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AbstractRecent findings related to the mesentery clarified the organisation of the abdomen at the foundational level. The Mesenteric-based model of abdominal anatomy articlulates a foundation that re-unites scientific and clinical approaches to the abdomen in health and disease. Importantly, recent advances are a reminder that we must always question dogma. The peritoneal-based dogma of conventional anatomy remained unquestioned for too long. With time, the mesenteric-based dogma will also be altered and improved on. Anatomy, and hence surgery, must always be considered as works in progress.

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Chou, C. K., C. W. Mak, C. C. Hou, J. M. Chang, and W. S. Tzeng. "CT of the mesenteric vascular anatomy." Abdominal Imaging 22, no. 5 (September 1997): 477–82. http://dx.doi.org/10.1007/s002619900242.

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Coffey, J. Calvin, W. Hohenberger, and R. Heald. "The Mesentery—Past, Present, and Future." Clinics in Colon and Rectal Surgery 35, no. 04 (July 2022): 265–68. http://dx.doi.org/10.1055/s-0042-1743429.

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AbstractThis article summarizes the events that shaped our current understanding of the mesentery and the abdomen. The story of how this evolved is intriguing at several levels. It speaks to considerable personal commitment on the part of the pioneers involved. It explains how scientific and clinical fields went different directions with respect to anatomy and clinical practice. It demonstrates that it is no longer acceptable to adhere unquestioningly to models of abdominal anatomy and surgery. The article concludes with a brief description of the Mesenteric Model of abdominal anatomy, and of how this now presents an opportunity to unify scientific and clinical approaches to the latter.

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Nuzhat, Ayesha. "Anatomy of Inferior Mesenteric Artery in Fetuses." Scientifica 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/5846578.

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Aim. To analyze Inferior Mesenteric Artery in fetuses through its site of origin, length, diameter, and variation of its branches.Method. 100 fetuses were collected from various hospitals in Warangal at Kakatiya Medical College in Andhra Pradesh, India, and were divided into two groups, group I (second-trimester fetuses) and group II (third-trimester fetuses), followed by dissection.Result.(1) Site of Origin. In group I fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra in 33 out of 34 fetuses (97.2%). In one fetus it was at first lumbar vertebra, 2.8%. In all group II fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra.(2) Length. In group I fetuses it ranged between 18 and 30 mm, average being 24 mm except in one fetus where it was 48 mm. In group II fetuses the length ranged from 30 to 34 mm, average being 32 mm.(3) Diameter. In group I fetuses it ranged from 0.5 to 1 mm, and in group II fetuses it ranged from 1 to 2 mm, average being 1.5 mm.(4) Branches. Out of 34 fetuses of group I, 4 fetuses showed variation. In one fetus left colic artery was arising from abdominal aorta, 2.9%. In 3 fetuses, Inferior Mesenteric Artery was giving a branch to left kidney, 8.8%. Out of 66 fetuses in group II, 64 had normal branching. In one fetus left renal artery was arising from Inferior Mesenteric Artery, 1.5%, and in another fetus one accessory renal artery was arising from Inferior Mesenteric Artery and entering the lower pole of left kidney.Conclusion. Formation, course, and branching pattern of an artery depend on development and origin of organs to attain the actual adult position.

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Coffey, J. Calvin, Mary Dillon, Rishabh Sehgal, Peter Dockery, Fabio Quondamatteo, Dara Walsh, and Leon Walsh. "Mesenteric-Based Surgery Exploits Gastrointestinal, Peritoneal, Mesenteric and Fascial Continuity from Duodenojejunal Flexure to the Anorectal Junction - A Review." Digestive Surgery 32, no. 4 (2015): 291–300. http://dx.doi.org/10.1159/000431365.

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Introduction: It is now well established that mesenteric-based colorectal surgery is associated with superior outcomes. Recent anatomic observations have demonstrated that the mesenteric organ is contiguous from the duodenojejunal to the anorectal junction. This led to similar observations in relation to associated peritoneum and fascia. The aim of this review was to demonstrate the relevance of the contiguity principle to resectional colorectal surgery. Methods: All literature in relation to mesenteric anatomy was reviewed from 1873 to the present, without language restriction. Results: Mesenteric-based surgery (i.e. complete mesocolic excision, total mesocolic and mesorectal excision) requires division of the peritoneal reflection (i.e. peritonotomy), and mesenteric mobilisation in the mesofascial plane. These are the fundamental technical elements of mesenterectomy. Mesenteric, peritoneal and fascial contiguity mean that in resectional surgery, these technical elements can be reproducibly applied at all levels from the origin at the superior mesenteric root, to the anorectal junction. Conclusions: The goals of complete mesocolic, total mesocolic and mesorectal excision can be universally achieved at any level from duodenojejunal flexure to anorectal junction, by adopting technical elements based on mesenteric, peritoneal and fascial contiguity.

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Gaivoronskii, I. V., P. M. Bykov, M. G. Gaivoronskaya, G. I. Sinenchenko, I. A. Goryacheva, G. I. Nichiporuk, and N. D. Verdiev. "Variant anatomy of the sigmoid branches of the inferior mesenteric artery." Journal of Anatomy and Histopathology 11, no. 1 (March 24, 2022): 22–27. http://dx.doi.org/10.18499/2225-7357-2022-11-1-22-27.

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Currently, the growing interest in the structure of the vascular stream of the colon is due to the rapid development of abdominal and colorectal surgery.The aim of research was to study the variant anatomy of the sigmoid branches of the inferior mesenteric artery in men and women.Material and methods. The study included findings of multi-slice spiral computed tomography; a total of 2300 computed tomograms of adults aged 25 to 75 years (913 men and 1387 women) were investigated. Variants of the architectonics of the inferior mesenteric artery were differentiated by the presence and nature of the origin of its sigmoid branches, for which standard axial images and a series of post-processing images were used.Results. There have been identified sequential, stem and mixed types of branching of the inferior mesenteric artery. In the sequential type, the left colic and all sigmoid arteries separate from the inferior mesenteric artery; with a stem, two or more branches depart from the inferior mesenteric artery by a common vessel; in the mixed type, two left colic arteries sequentially depart from the inferior mesenteric artery. It has been proven that in both sexes the predominant type of branching of the inferior mesenteric artery is the stem: in men it is noted in 62% of cases, in women – in 63%, the mixed type of branching of the inferior mesenteric artery is the rarest, noted only in 2.4% of cases.Conclusion. The obtained information is of practical significance in abdominal, vascular, X-ray endovascular surgery, transplantology, coloproctology, and radiation diagnostics.

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Zhao, Yan E., Zhen Jane Wang, Chang Sheng Zhou, Fei Peng Zhu, Long Jiang Zhang, and Guang Ming Lu. "Multidetector Computed Tomography of Superior Mesenteric Artery: Anatomy and Pathologies." Canadian Association of Radiologists Journal 65, no. 3 (August 2014): 267–74. http://dx.doi.org/10.1016/j.carj.2013.10.001.

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The recent introduction of multidetector computed tomography scanners has significantly improved computed tomography angiographic (CTA) applications, especially for the evaluation of medium- and small-arterial structures. CTA of the superior mesenteric artery has been reported previously. However, there have been few systematic and detailed reviews of the superior mesenteric artery pathologies that use CTA. The purpose of this pictorial essay is mainly to review the various superior mesenteric artery pathologies at CTA with our own experiences.

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Ognjanovic, Neda, D. Jeremic, Ivana Zivanovic-Macuzic, Maja Sazdanovic, P. Sazdanovic, Irena Tanaskovic, J. Jovanovic, et al. "MDCT angiography of anatomical variations of the celiac trunk and superior mesenteric artery." Archives of Biological Sciences 66, no. 1 (2014): 233–40. http://dx.doi.org/10.2298/abs1401233o.

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The aim of this study was to detect and describe the existence and incidence of anatomical variations of the celiac trunk and superior mesenteric artery. The study was conducted on 150 persons, who underwent abdominal Multi- Detector Computer Tomography (MDCT) angiography, from April 2010 until November 2012. CT images were obtained with a 64-row MDCT scanner in order to analyze the vascular anatomy and anatomical variations of the celiac trunk and superior mesenteric artery. In our study, we found that 78% of patients have a classic anatomy of the celiac trunk and superior mesenteric artery. The most frequent variation was the origin of the common hepatic artery from the superior mesenteric artery (10%). The next variation, according to frequency, was the origin of the left gastric artery direct from the abdominal aorta (4%). The arc of Buhler as an anastomosis between the celiac trunk and superior mesenteric artery, was detected in 3% of cases, as was the presence of a common trunk of the celiac trunk and superior mesenteric artery (in 3% of cases). Separate origin of the splenic artery and the common hepatic artery was present in 2% of patients. The MDCT scanner gives us an insight into normal anatomy and variations of the abdominal blood vessels, which is very important in the planning of surgical interventions, especially transplantation, as well as in the prevention of complications due to ischemia.

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Dritsas, Eric R., Oscar R. Ruiz, G. Mitchell Kennedy, James Blackford, and David Hasl. "Paraduodenal Hernia: A Report of Two Cases." American Surgeon 67, no. 8 (August 2001): 733–36. http://dx.doi.org/10.1177/000313480106700803.

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Paraduodenal hernias are uncommon congenital herniations into the mesentery of the colon that present as small bowel obstruction. The diagnosis is elusive but may be made by CT scan or upper gastrointestinal series. There are three types: left, right, and transverse. The repair involves reduction of the hernia and closure of the mesenteric defect in accordance with the anatomy of the hernia. We present two cases of paraduodenal hernia that are representative of this unusual class of internal herniation.

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Russkikh, Andrey N. "Human portal system morphometry based on 3D computer aided modelling." European Journal of Anatomy 26, no. 2 (March 2022): 159–66. http://dx.doi.org/10.52083/ouwb2921.

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There is no discussion about human portal system variability. Features of interposition, veins branching included in this system, stereometric and lineal characteristics define its development, stream and ways of operation interference for several surgery diseases, which all in all decides the end of surgery pathology. Morphometry study of portal system using computer-aided modelling and methods of computational anatomy has been performed. DICOM data segmentation was performed using Dragonfly software (Object Research Systems, Canada) at the Innovation Technology Management Resources of the Reaviz University. Using series with arterial and vein contrast, we performed the segmentation of contrasting vessels, obtained three-dimensional data topology in .obj format. Then we processed the obtained models using scripts prepared for the pythonOCC framework. We built the central lines of the vessels and formed the branching tree. Methods of computational hemodynamics were implemented using the Visual-CFD application for OpenFOAM environment (ESI, France). Veins forming the portal vein are presented by three systems; in every one of them there are scapi and affluxes, which are different in branching types and other morphological characteristics. The superior mesenteric vein, for instance, is characterized by interjacent branching type, has one scapus 93,5 (78,5; 119,5) mm in length and diameter 9,5 (6,5; 12,0) mm, going to portal vein under the corner 170,0 (160,0; 175,0)0, and formed by venous inflows of majority unpaired organs of upper and down floors in abdominal cavity. Affluxes of the superior mesenteric vein have almost the same diameter from 3,5 to 12 mm but the length. The shortest affluxes are jejunal ones (40,0 (38,5; 46,5) mm) and right gastroepiploic vein (45,0 (38,5; 53,5) mm), then iliac (50,0 (48,5; 53,5) mm), middle colonic (60,0 (58,5; 63,5) mm) and iliac colonic (70,0 (68,5; 78,5) mm) veins. The system of inferior mesenteric vein contains a lower number of veins going to its bed in comparison with vessels net of superior mesenteric vein. Magistral type of branching of inferior mesenteric vein is found in 23% of cases and in 77% of cases it has interjacent type of branching. In case of interjacent type of branching mesenteric vein goes to superior mesenteric vein between right colonic and jejuna veins. Inferior mesenteric vein of magistral type goes to splenic vein in most cases (as it is shown on picture 1) or it is independent afflux of portal vein. Its diameter is significantly less than diameter of superior mesenteric vein and makes 4,5 (2,0; 6,5) mm. The current research gives quantitative orienting points for main vein structures of portal vein system. The research results have allowed adding science materials about types of branching and morphological patterns of portal vein and its branching. Variations common for every system are preferably being used for regulation of the discussed subject in terms of tactic patients’ curing with syndrome of portal hypertension or at the step of pre surgical preparation.

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Shin, James, Paul J. Shin, and Roger J. Bartolotta. "SMA-like syndrome with variant mesenteric venous anatomy." Clinical Imaging 48 (March 2018): 86–89. http://dx.doi.org/10.1016/j.clinimag.2017.03.013.

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FONSECA-NETO, Olival Cirilo Lucena da, Heloise Caroline de Souza LIMA, Priscylla RABELO, Paulo Sérgio Vieira de MELO, Américo Gusmão AMORIM, and Cláudio Moura LACERDA. "ANATOMIC VARIATIONS OF HEPATIC ARTERY: A STUDY IN 479 LIVER TRANSPLANTATIONS." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 30, no. 1 (March 2017): 35–37. http://dx.doi.org/10.1590/0102-6720201700010010.

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ABSTRACT Background: The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure. Aim: To identify the anatomical variations in the hepatic arterial system in hepatic transplantation. Methods: 479 medical records of transplanted adult patients in the 13-year period were retrospectively analyzed, and collected data on hepatic arterial anatomy of the deceased donor. Results: It was identified normal hepatic arterial anatomy in 416 donors (86.84%). The other 63 patients (13.15%) showed some variation. According to the Michels classification, the most frequently observed abnormalities were: right hepatic artery branch of superior mesenteric artery (Type III, n=27, 5.63%); left hepatic artery branch of the left gastric artery (Type II, n=13, 2.71%); right hepatic artery arising from the superior mesenteric artery associated with the left hepatic artery arising from the left gastric artery (Type IV, n=4, 0.83%). Similarly, in relation to Hiatt classification, the most prevalent changes were: right hepatic accessory artery or substitute of the superior mesenteric artery (Type III, n=28, 6.05%)), followed by liver ancillary left artery or replacement of gastric artery left (Type II, n=16, 3.34. Fourteen donors (2.92%) showed no anatomical abnormalities defined in classifications, the highest frequency being hepatomesenteric trunk identified in five (01.04%). Conclusion: Detailed knowledge of the variations of hepatic arterial anatomy is of utmost importance to surgeons who perform approaches in this area, particularly in liver transplantation, since their identification and proper management are critical to the success of the procedure.

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Kriger, A. G., N. A. Pronin, M. V. Dvukhzhilov, D. S. Gorin, A. V. Pavlov, and G. G. Karmazonovsky. "Surgical glance at pancreatic arterial anatomy." Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery 26, no. 3 (September 15, 2021): 112–22. http://dx.doi.org/10.16931/1995-5464.2021-3-112-122.

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Aim. Study of anatomical variations of the pancreatic neck blood supply, which may affect the results of pancreaticoduodenectomy.Material and methods. Anatomic characteristics of arterial blood supply of pancreas were studied in 42 autopsied cases, who died from diseases not associated with abdominal organs failure. Clinical part of our study included 62 patients. Arterial anatomy was examined during early arterial phase of computer tomography. Options of the origin of the dorsa pancreatic artery were noted. All patients had “soft” pancreas confirmed by morphological examination and computer tomography. Main group included 20 patients. Dissection of the pancreas during pancreatoduodenectomy in this group were performed 10–15 mm left of portal vein confluence. Control (retrospective) group included 42 patients performed standard procedure, when pancreas was dissected above the portal vein confluence.Results. It was found that the neck of pancreas was supplied from dorsal pancreatic artery, found in all specimens. In 76% of cases it was a branch of splenic artery, in other cases – a branch of superior mesenteric artery. CT scan revealed the dorsal pancreatic artery in 54 (87.1%) people, in 8 patients the artery could not be identified. The dorsal pancreatic artery was a branch of the splenic artery in 64.8% of cases. In other cases it was a branch of the superior mesenteric artery, common hepatic artery, gastroduodenal artery and middle colon artery. If the dorsal pancreatic artery was a branch of the superior mesenteric, common hepatic, gastroduodenal artery, it was transected during lymphadenectomy. This led to higher frequency of postoperative pancreatic fistula.Conclusion. Localization of dorsal pancreatic artery must be taken into account during the pancreatoduodenectomy. That allows to decrease probability of postoperative pancreatic fistula.

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Covanțev, Serghei, Natalia Mazuruc, and Olga Belic. "An unusual case of colon vascularization by the inferior mesenteric artery." Jornal Vascular Brasileiro 16, no. 1 (April 10, 2017): 52–55. http://dx.doi.org/10.1590/1677-5449.009315.

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Abstract In this article we present a rare variant in which the large intestine was vascularized by the inferior mesenteric artery. It was encountered during macro and microscopic dissection of the cadaver of a 63-year-old woman at a university department of human anatomy. In this case, the ascending, transverse, descending, and sigmoid colon and rectum were vascularized by the inferior mesenteric artery, whereas the small intestine, cecum and appendix were supplied by the superior mesenteric artery.

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Gordeeva, Alina E., Mars G. Sharapov, Irina V. Tikhonova, Nikolay K. Chemeris, Evgeniy E. Fesenko, Vladimir I. Novoselov, and Andrey A. Temnov. "Vascular Pathology of Ischemia/Reperfusion Injury of Rat Small Intestine." Cells Tissues Organs 203, no. 6 (2017): 353–64. http://dx.doi.org/10.1159/000455830.

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Ischemia/reperfusion (I/R) injury of the small intestine caused by occlusion of the superior mesenteric artery affects the intestinal tissue as well as components of the blood circulatory system from the microvasculature to mesenteric vessels. The aim of this work was to study the correlation between the dynamics of destruction development in the intestinal tissue, microvasculature, and mesenteric vessels in I/R of the small intestine. The microvasculature was analyzed by whole-organ continuous monitoring of the intestinal mucosal blood perfusion by laser Doppler flowmetry during the entire I/R. Real-time RT-PCR was used to assess gene expression of NF-κB, caspase-3, Ki67, and TNF-α in blood vessels. At the start of reperfusion, the first targets to be disrupted are microvessels in the apical villi. Injury of the apical part of the microcirculatory bloodstream correlates with the reduction in intestinal mucosal blood perfusion, which occurred simultaneously with apical villous destruction. By the end of the reperfusion period, the low intestinal mucosal blood perfusion is mirrored by the destruction of the microvasculature and mucosal structures in the entire organ. The development of mesenteric vessel injury is characterized by a change in NO metabolism and damaged endothelial cells concomitant with an alteration in the expression of genes encoding NF-κB, caspase-3, and Ki67 by the end of the reperfusion period. In I/R injury, detrimental effects on the intestinal tissue, microvasculature, and mesenteric vessels develop and exhibit common mechanisms of function, which show strong correlations.

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Zerin, J. M., and M. A. DiPietro. "Mesenteric vascular anatomy at CT: normal and abnormal appearances." Radiology 179, no. 3 (June 1991): 739–42. http://dx.doi.org/10.1148/radiology.179.3.2027985.

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Macpherson, Andrew J., and Karen Smith. "Mesenteric lymph nodes at the center of immune anatomy." Journal of Experimental Medicine 203, no. 3 (March 13, 2006): 497–500. http://dx.doi.org/10.1084/jem.20060227.

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The surface of the intestinal mucosa is constantly assaulted by food antigens and enormous numbers of commensal microbes and their products, which are sampled by dendritic cells (DCs). Recent work shows that the mesenteric lymph nodes (MLNs) are the key site for tolerance induction to food proteins and that they also act as a firewall to prevent live commensal intestinal bacteria from penetrating the systemic immune system.

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Akpinar, E., B. Turkbey, M. Karcaaltincaba, D. Karaosmanoglu, and D. Akata. "MDCT of inferior mesenteric vein: normal anatomy and pathology." Clinical Radiology 63, no. 7 (July 2008): 819–23. http://dx.doi.org/10.1016/j.crad.2007.09.001.

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Anthony, A., R. E. Pounder, A. P. Dhillon, and A. J. Wakefield. "Vascular anatomy defines sites of indomethacin induced jejunal ulceration along the mesenteric margin." Gut 41, no. 6 (December 1, 1997): 763–70. http://dx.doi.org/10.1136/gut.41.6.763.

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Background—Indomethacin induces ulceration in the rat jejunum with sparing of the ileum. The ulcers localise between vasa recta along the mesenteric margin of the bowel, observations that have not been fully explained.Aim—To examine the relationship between the localisation of experimental ulcers and the vascular anatomy of the rat small intestine.Methods—The normal vascular anatomy of the rat jejunum and ileum was studied and compared using arterial carbon ink perfusion. The anatomical localisation of early and advanced lesions induced by indomethacin was examined with particular reference to the vasculature. Mucosal injury induced by feeding vessel ligation for 24 hours or brief ischaemia-reperfusion injury was examined. The existence of anatomically sensitive sites to indomethacin was tested in a two dose study.Results—In the rat jejunum, poorly vascularised sites along the mesenteric margin were highly susceptible to indomethacin induced injury, such sites being absent from the ileum. Villous contraction was a feature of both early indomethacin injury and ischaemia-reperfusion injury in the rat jejunum. Twenty four hour ligation of jejunal vasa brevia selectively induced ischaemic injury along the mesenteric margin. Two doses of indomethacin to rats did not induce greater injury than a single dose.Conclusions—Results support the hypothesis that the rat jejunum possesses vascularly compromised sites along the mesenteric margin that are susceptible to indomethacin induced injury. Indomethacin may cause ischaemia-reperfusion injury selectively at these sites.

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Mirilas, Petros, and John E. Skandalakis. "Surgical Anatomy of the Retroperitoneal Spaces, Part IV: Retroperitoneal Nerves." American Surgeon 76, no. 3 (March 2010): 253–62. http://dx.doi.org/10.1177/000313481007600303.

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We present surgicoanatomical topographic relations of nerves and plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral plexus is formed by the lumbosacral trunk, ventral rami of S1–S3, and part of S4; the remainder of S4 joining the coccygeal plexus. From this plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (prevertebral) plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).

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Müller, P., K. Randhawa, and KJ Roberts. "Preoperative identification of anomalous arterial anatomy at pancreaticoduodenectomy." Annals of The Royal College of Surgeons of England 96, no. 5 (July 2014): e34-e36. http://dx.doi.org/10.1308/003588414x13946184901768.

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The understanding of abdominal vascular anatomy and its anatomical variations is of considerable importance in upper abdominal surgery. We present the rare finding of a common hepatic artery arising from the superior mesenteric artery and passing anterior to the pancreatic gland in a patient undergoing a pancreaticoduodenectomy.

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Patel, Rajiv M., Sharon W. Weiss, and Andrew L. Folpe. "Heterotopic Mesenteric Ossification." American Journal of Surgical Pathology 30, no. 1 (January 2006): 119–22. http://dx.doi.org/10.1097/01.pas.0000184820.71752.20.

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Emory, Theresa S., James M. Monihan, Norman J. Carr, and Leslie H. Sobin. "Sclerosing Mesenteritis, Mesenteric Panniculitis and Mesenteric Lipodystrophy: A Single Entity?" American Journal of Surgical Pathology 21, no. 4 (April 1997): 392–98. http://dx.doi.org/10.1097/00000478-199704000-00004.

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Muro, Satoru, Wachirawit Sirirat, Daisuke Ban, Yuichi Nagakawa, and Keiichi Akita. "What comprises the plate-like structure between the pancreatic head and the celiac trunk and superior mesenteric artery? A proposal for the term “P–A ligament” based on anatomical findings." Anatomical Science International 96, no. 3 (January 8, 2021): 370–77. http://dx.doi.org/10.1007/s12565-020-00597-1.

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AbstractA plate-like structure is located posterior to the portal vein system, between the pancreatic head and roots and/or branches of two major arteries of the aorta: the celiac trunk and superior mesenteric artery. We aimed to clarify the distribution and components of this plate-like structure. Macroscopic examination of the upper abdomen and histological examination of the plate-like structure were performed on 26 cadavers. The plate-like structure is connected to major arteries (aorta, celiac trunk, superior mesenteric artery) and the pancreatic head; it contains abundant fibrous bundles comprising nerves, vessels, collagen fibers, and adipose tissue. Furthermore, it consists of three partly overlapping fibrous components: rich fibrous bundles (superior mesenteric artery plexus) fused to the uncinate process of the pancreas; fibrous bundles arising from the right celiac ganglion and celiac trunk that spread radially to the dorsal side of the pancreatic head and superior mesenteric artery plexus; and fibrous bundles, accompanied by the inferior pancreaticoduodenal artery, entering the pancreatic head. The plate-like structure is the pancreas–major arteries (aorta, celiac trunk, superior mesenteric artery) ligament (P–A ligament). The term “P–A ligament” may be clinically useful and can facilitate comprehensive understanding of the anatomy surrounding the pancreatic head and provide an anatomical basis for further pancreatic surgery studies.

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Parker, Dominic Robert, Philip Kiely, and Richard Smith. "Complete resection of a massive mesenteric lymphangioma in an adult." BMJ Case Reports 13, no. 3 (March 2020): e233714. http://dx.doi.org/10.1136/bcr-2019-233714.

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Mesenteric lymphangioma is a benign cystic tumour of the lymphatic vessels that occurs rarely in adults. Due to the infrequency of cases and the insidious presentation, these tumours can be diagnosed late and become massive. Resection of mesenteric lymphangioma in its entirety is the recommended management in order to prevent recurrence. This case report describes the finding of a massive mesenteric lymphangioma (dimensions 420×470×100 mm) in a young man, the investigations leading to diagnosis, and the subsequent surgical management. The substantial size of this tumour produced considerable challenges for the surgical team, including involvement of adjacent small bowel and mesenteric vasculature. Preoperative diagnosis and assessment of the anatomy was pivotal in achieving a complete resection and a good patient outcome.

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Estruc, T., R. Nascimento, N. Siston, R. Mencalha, and M. Abidu-Figueiredo. "Origin and main branches of the cranial and caudal mesenteric arteries in the New Zealand rabbit." Journal of Morphological Sciences 32, no. 03 (July 2015): 143–48. http://dx.doi.org/10.4322/jms.081714.

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Abstract Introduction: Precise knowledge of variations in arterial vascularization of the abdominal viscera is important for systematization of radiological and surgical anatomy in animals that serve as experimental models and in domestic animals. Objective: The aim of this study was to describe the origin and main branches of the cranial and caudal mesenteric arteries in rabbits. Materials and Methods: The anatomical dissections were performed in 30 cadavers of adult rabbits, 15 males and 15 females. Results: The cranial mesenteric artery arose as a single artery in all females and males. The average length of the cranial mesenteric artery in females was 2.63 cm and originated at the level oflst lumbar vertebra in two (13.33%) animals, between the 1st and 2nd lumbar vertebra in four (26.67%), on the 2nd lumbar vertebra in seven (46.67%), between 2nd and 3rd lumbar vertebra in one (6.67%) and at the level of 3rd lumbar vertebra in one (6.67%). The average length of the cranial mesenteric artery in males was 2.56 cm and originated at the level of1st lumbar vertebra in two (13.33%) animals, between the 1st and 2nd lumbar vertebra in two (13.33%), at the level of the 2nd lumbar vertebra in eight (53.33%), between the 2nd and 3rd lumbar vertebra in three (20%). The main ramifications of the cranial mesenteric artery were the caudal pancreatic duodenal, middle colic, jejunal and ileocecocolic arteries. The caudal mesenteric artery arose as a single artery in all females and males. The average length of the caudal mesenteric artery in females was 0.846 cm and originated at the level of 5th lumbar vertebra in three (20%) animals, between the 5th and 6th lumbar vertebra in two (13.33%), at the level of the 6th lumbar vertebra in seven (46.67%), %), between the 6th and 7th lumbar vertebra in two (13.33%) and at the level of the 7th lumbar vertebra in one (6.67%). The average length of the caudal mesenteric artery in males was 0.79 cm and originated at the level of the 5th lumbar vertebra in two (13.33%) animals, between the 5th and 6th lumbar vertebra in one (6.67%), at the level of the 6th lumbar vertebra in seven (46.67%), between the 6th and 7th lumbar vertebra in four (26.67%) and at the level of the 7th lumbar vertebra in one (6.67%). The caudal mesenteric artery arises from the aorta, originating the cranial rectal and left colic arteries. Conclusion: No relation was observed between the mesenteric length and the rostrum-sacral length in rabbits. The origin of the cranial and caudal mesenteric artery is not gender dependent.

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Gupta, Prerna, and Neeraj Gupta. "Course and Variations in Branches of Inferior Mesenteric Artery." PERSPECTIVES IN MEDICAL RESEARCH 9, no. 1 (May 15, 2021): 17–20. http://dx.doi.org/10.47799/pimr.0901.04.

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Background : The mesenteric blood supply is a combination of rich collateral networks. There are frequent anatomical variants encountered and these variations are sometimes involved in pathologies. Treatment of which requires a better understanding of the variations in the normal anatomy of the inferior mesenteric artery. Methods : The present study was carried out in the Department of Anatomy, Prathima Institute of Medical Sciences, Karimnagar. A total of n=50 specimens, with n=17 adult males and n=2 adult female cadavers and fetuses of which n=26 were term and n=2, was preterm. Female fetuses n=2 of term and n=1 preterm were included in the study. Results : The following variations were observed in the present study of course and variations in the branches of the inferior mesenteric artery and are grouped into three types. Type I: In this type middle colic artery is arising from the inferior mesenteric artery instead of the superior mesenteric artery. It is a rare-variations and observed in a female fetus. Type-II: Four Sigmoidal arteries are arising from an inferior mesenteric artery, after the origin of the left colic artery. This type is observed in a male fetus. Type-III: Three Sigmoidal arteries are originated from the inferior mesenteric artery. This type was observed in a male adult and a male fetus. Conclusion: Out of the 50 cases included in the study we found type 1 variation of IMA in 2% of cases, type 2 variation was found in 2% samples, and type 3 variation was found in 4% of samples. Based on the variations radiologists and Surgeons should be aware of possible consequences when doing colectomy, right hemicolectomy, left hemicolectomy, sigmoidectomy, en-bloc resection of the head of the pancreas, aneurysm, and chronic bowel ischemia. The present study is also useful for reconstructive surgeries in inferior mesenteric arteries in the case of ischemia.

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Pal, Dolan Champa, Karabi Baral, Jayanta Sarkar, and Koushik Ray. "Vascular variations in abdomen, face and neck in a single cadaver." National Journal of Clinical Anatomy 04, no. 01 (January 2015): 035–37. http://dx.doi.org/10.1055/s-0039-3401541.

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AbstractDuring Routine dissection at Bankura Sammilani Medical College, multiple vascular variations were detected in a cadaver of 60 years aged female. Variation in formation of hepatic portal vein was present as union of splenic vein with the common trunk formed by Superior mesenteric vein & Inferior mesenteric vein. Second variations were in unilateral facial vessels, where the right facial artery terminated as superior labial artery and the right common facial vein drained into the External jugular vein. Knowledge of variant anatomy of hepatic portal vein is essential for surgical and interventional procedures because large visceral territory drained by inferior mesenteric vein. Knowledge of Facial vessels is important for maxillofacial surgeries.

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Mohamed, R. "Anatomical studies on the cranial and caudal mesenteric arteries of the Barbados Black Belly sheep." Journal of Morphological Sciences 34, no. 02 (April 2017): 093–97. http://dx.doi.org/10.4322/jms.112017.

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Abstract Introduction: The Barbados Black Belly is a breed of domestic sheep in the Caribbean island of Trinidad. Anatomical studies on the cranial and caudal mesenteric arteries are necessary to know the pattern of its blood supply to gain information in benefit of experimental surgery. Materials and Methods: The thoracic part of the aorta of five sheep was injected with red latex. Careful gross dissection of the cranial and caudal mesenteric arteries was performed either after embedding in 10% formalin solution for 2-3 days. Results: The cranial mesenteric artery originated from the abdominal aorta, caudally to the celiac trunk, giving caudal duodenal artery, jejunal arteries, ileal arteries, ileocolic artery and middle colic artery. The caudal mesenteric artery arises from the aorta, cranially to the external iliac arteries, originating the left colic and cranial rectal arteries. Conclusion: cranial and caudal mesenteric arteries supplied the small and large intestine of the Barbados Black Belly sheep except caudal part of the large intestine which were supplied by the middle and caudal rectal arteries.

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Rubtsova, N. A., M. N. Pheduleev, Y. I. Nerestyuk, D. K. Khamidov, D. V. Sidorov, M. V. Lozhkin, and A. D. Kaprin. "Arterial blood supply to the liver, celiac and mesenteric pool (literature review)." Medical Visualization 25, no. 2 (May 18, 2021): 74–83. http://dx.doi.org/10.24835/1607-0763-928.

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Knowledge of the variant vascular anatomy of the celiac and mesenteric basin is of paramount importance in operative interventions in the hepatopancreatobiliary zone, stomach and duodenum, liver transplantation. The article presents various classifications of vessels of the celiac and mesenteric basin, created by the authors as a result of numerous studies using various techniques. The main advantages and disadvantages of the main classifications of blood vessels are considered, the features of application in clinical practice are given.

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Hassan, S., and A. El-Sayed. "Gross Anatomy of the Celiac, Cranial Mesenteric and Caudal Mesenteric Arteries in Hooded Crow (Corvus cornix)." Journal of Veterinary Anatomy 11, no. 2 (October 1, 2018): 41–55. http://dx.doi.org/10.21608/jva.2018.44908.

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Rawal, Sushil, Dhan Bahadur Shrestha, Bikash Bikram Thapa, Kunda Bikram Shah, and Manoj Jha. "Acute Abdomen: An Enigma." Nepalese Medical Journal 1, no. 1 (June 22, 2018): 47–49. http://dx.doi.org/10.3126/nmj.v1i1.20401.

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Mesenteric infarction is a surgical emergency presenting as acute abdomen. Here we present a case of unexpected diagnosis of acute mesenteric infarction. He underwent emergency laparotomy with resection of the gangrenous bowel and end- end anastomosis of remaining 140 cm small bowel left. In two weeks period patient develop recurrence of disease which was successfully managed with conservative treatment. Further detailed investigation revealed the bizarre arterial anatomy with occlusion at multiple sites.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 48-50

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Salehzadeh, F., Ali Samadi, and M. Mirzarahimi. "Superior Mesenteric Artery Syndrome in a 6-Year-Old Girl with Final Diagnosis of Celiac Disease." Case Reports in Gastrointestinal Medicine 2019 (April 8, 2019): 1–3. http://dx.doi.org/10.1155/2019/3458601.

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Background. Superior mesenteric artery syndrome (SMAS) occurs when the duodenum is compressed between the two arteries, superior mesenteric artery and aorta. The complications of this rarely found disorder in children range from causing trouble in duodenal functions to intestinal obstruction which is potentially life-threatening. Case Presentation. Here we are reporting a case of SMAS in a 6-year-old girl with the complaint of chronic abdominal pain since 3 years. She suffered from growth failure, while different workups were negative. Ultimately, imaging investigations detected superior mesenteric artery syndrome as an etiologic background. In the additional investigations, it is found that she suffered from celiac disease. Conclusion. We concluded that the inflammatory nature of the celiac disease can affect the anatomy of the duodenum beyond its mucosal surface in the mesenteric fat tissue and results in SMAS.

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Jayagandhi, Sakkarai, Khizer Hussain Afroze M, Kidiyoor Anup Rao, Suman Verma, and Sangeeta M. "Persistence of Ventrolateral Splanchnic Longitudinal Channels." International Journal of Anatomy and Research 10, no. 3 (September 5, 2022): 8452–56. http://dx.doi.org/10.16965/ijar.2022.191.

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The coeliac trunk is the branch of the abdominal aorta at the level of the twelfth thoracic vertebra. Its branches namely left gastric, common hepatic and splenic arteries supply the primary organs of the supracolic abdominal compartment namely the stomach, pancreas, spleen and liver. In this article, we report case series of three cases in male cadavers aged 65yrs, 60yrs and 70yrs respectively in the Department of Anatomy, Pondicherry Institute of Medical Sciences and MVJ Medical College and Research Institute wherein we discovered that the branching pattern of the coeliac trunk varied from the usual pattern, thus the specimens were photographed to understand further. The observation of first case, common trunk from abdominal aorta showed common hepatic and superior mesenteric artery and left gastric and splenic artery aroused as another common trunk from abdominal aorta. The second case showed the superior mesenteric artery arising from coeliac trunk and the third case was observed the inferior phrenic arteries were arising from coeliac trunk. Knowledge of this variable anatomy may be useful in planning and executing surgical or radiological interventions. KEY WORDS: Ventral splanchnic vessels, coeliac trunk, Superior mesenteric Artery, Inferior Phrenic artery, vascular variations.

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Nelson, Thomas M., Raymond Pollak, Olga Jonasson, and Herand Abcarian. "Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance." Clinical Anatomy 1, no. 2 (1988): 75–91. http://dx.doi.org/10.1002/ca.980010202.

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Horton, Karen M., and Elliot K. Fishman. "Volume-rendered 3D CT of the Mesenteric Vasculature: Normal Anatomy, Anatomic Variants, and Pathologic Conditions." RadioGraphics 22, no. 1 (January 2002): 161–72. http://dx.doi.org/10.1148/radiographics.22.1.g02ja30161.

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39

Wendel, Martina, Wolfgang Kummer, Lilla Knels, Joachim Schmeck, and Thea Koch. "Muscular ETB Receptors Develop Postnatally and Are Differentially Distributed in Specific Segments of the Rat Vasculature." Journal of Histochemistry & Cytochemistry 53, no. 2 (February 2005): 187–96. http://dx.doi.org/10.1369/jhc.4a6474.2005.

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The endothelin/endothelin-receptor system is a key player in the regulation of vascular tone in mammals. We raised and characterized an antiserum against rat ETB receptor and investigated the distribution of ETB receptors in different vascular beds during postnatal development (day 0 through day 28) and in the adult rat. We report the tissue-specific and age-dependent presence of vasoconstrictor ETB receptors. At the time of birth, vascular smooth muscle cells from all tissues examined did not exhibit ETB receptor immunoreactivity. The occurrence of ETB receptor immunoreactivity in the postnatal development was time dependent and started in small coronary and meningeal arteries at day 5, followed by small mesenteric arteries as well as brachial artery and vein at day 14. At day 21, ETB receptors were present in the media of muscular segments of pulmonary artery, large coronary arteries, and intracerebral arterioles. At day 28, ETB receptor immunoreactivity was evident in interlobular renal arteries, vas afferens, and efferens. Large renal arteries, mesenteric artery, and elastic segments of pulmonary arteries, as well as coronary and mesenteric veins, did not exhibit ETB receptor immunoreactivity. These data demonstrate the age-dependent and tissue-specific presence of ETB receptors, mainly on arterial smooth muscle cells in the vascular system of the rat.

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Yano, Mitsuhiro, Shinji Okazaki, Ichiro Kawamura, Shunichiro Ito, Shintaro Nozu, Yuya Ashitomi, Takefumi Suzuki, Yukinori Kamio, and Osamu Hachiya. "A three-dimensional computed tomography angiography study of the anatomy of the accessory middle colic artery and implications for colorectal cancer surgery." Surgical and Radiologic Anatomy 42, no. 12 (June 4, 2020): 1509–15. http://dx.doi.org/10.1007/s00276-020-02511-w.

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Abstract Purpose In the present study, we focused on the accessory middle colic artery and aimed to increase the safety and curative value of colorectal cancer surgery by investigating the artery course and branching patterns. Methods We included 143 cases (mean age, 70.4 ± 11.2 years; 86 males) that had undergone surgery for neoplastic large intestinal lesions at the First Department of Surgery at Yamagata University Hospital between August 2015 and July 2018. We constructed three-dimensional (3D) computed tomography (CT) angiograms and fused them with reconstructions of the large intestines. We investigated the prevalence of the accessory middle colic artery, the variability of its origin, and the prevalence and anatomy of the arteries accompanying the inferior mesenteric vein at the same level as the origin of the inferior mesenteric artery. Results Accessory middle colic artery was observed in 48.9% (70/143) cases. This arose from the superior mesenteric artery in 47, from the inferior mesenteric artery in 21, and from the celiac artery in two cases. In 78.2% (112/143) cases, an artery accompanying the inferior mesenteric vein was present at the same level as the origin of the inferior mesenteric artery; this artery was the left colic artery in 92, the accessory middle colic artery in 11, and it divided and became the left colic artery and the accessory middle colic artery in 10 cases. Conclusion 3D CT angiograms are useful for preoperative evaluation. Accessory middle colic arteries exist and were observed in 14.9% of cases.

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Balcerzak, Adrian, Richard Shane Tubbs, Anna Waśniewska‐Włodarczyk, Elżbieta Rapacka, and Łukasz Olewnik. "Classification of the superior mesenteric artery." Clinical Anatomy 35, no. 4 (March 7, 2022): 501–11. http://dx.doi.org/10.1002/ca.23841.

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Kitamura, Seiichiro, Takahiko Nishiguchi, Akira Sakai, and Kenzo Kumamoto. "Rare case of the inferior mesenteric artery arising from the superior mesenteric artery." Anatomical Record 217, no. 1 (January 1987): 99–102. http://dx.doi.org/10.1002/ar.1092170113.

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Kolsanov, Aleksandr V., Maksim N. Myakotnykh, Aleksey A. Mironov, and Renat R. Yunusov. "ANATOMICAL VARIANTS OF INFERIOR MESENTERIC VEIN ACCORDING ON THE DATA OF MULTISPIRAL COMPUTED TOMOGRAPHY." Morphological newsletter 28, no. 4 (February 28, 2021): 31–37. http://dx.doi.org/10.20340/mv-mn.2020.28(4):444.

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Knowledge of the variants of the anatomical variability of the liver vascular bed can be of critical importance in liver resection, liver transplantation, laparoscopic operations, resection of the pancreas, surgical treatment of portal hypertension The main vessels of the hepatic portal vein system are characterized by pronounced anatomical variability in the formation of the portal vein trunk, the greatest variability is characterized by inferior mesenteric vein. The aim of the investigation was to study the variant anatomy of the inferior mesenteric vein according to multispiral computed tomography. The material was 100 multispiral computed tomograms of the abdominal organs from the archive of the clinics of the Samara State Medical University for 2018-2019. For mathematical modeling and the creation of three-dimensional models based on tomograms of the vascular bed, plugins were used in the programs «Luch» and «Autoplan». Variants of the portal vein formation, the angle of inflow of the inferior mesenteric vein into the superior mesenteric and splenic veins, the distance from the point of confluence of the inferior mesenteric vein to the point of confluence with the portal vein were studied. The study revealed that the inferior mesenteric vein in 40% of cases flows into the splenic vein, in 39% - into the angle of confluence of the superior mesenteric and splenic veins, in 16% - into the superior mesenteric vein. In 5% of cases, the absence of the inferior mesenteric vein was revealed. The angle of fusion of the inferior mesenteric vein with the superior mesenteric vein was statistically significantly greater than the angle of fusion of the inferior mesenteric vein with the splenic vein. The angles were 76.36 ± 1.53 ° and 64.89 ± 3.52 °, respectively (p = 0.004). The length of the common trunk of the inferior mesenteric and splenic veins was significantly greater than the common trunk of the mesenteric veins and amounted to 16.98 ± 1.09 mm and 9.37 ± 0.65 mm (p = 0.001), respectively. Thus, the study showed a high degree of anatomical variability of the inferior mesenteric vein.

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Sasaki, Katsunori. "Three-dimensional analysis of erythrophagosomes in rat mesenteric lymph node macrophages." American Journal of Anatomy 188, no. 4 (August 1990): 373–80. http://dx.doi.org/10.1002/aja.1001880405.

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Makarova, V. N., I. I. Kuznetsov, S. S. Bachurin, and I. A. Kolomoets. "Forensic medical evaluation of an isolated injury of the small bowel mesentery and its vessels (literature review extended with expert case report)." Medical Herald of the South of Russia 12, no. 4 (October 26, 2021): 101–7. http://dx.doi.org/10.21886/2219-8075-2021-12-4-101-107.

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This work summarizes information from the modern scientific literature devoted to the issues of morphology and mechanisms of an isolated mesenteric injury, which is rare in expert practice. Apart from classic forensic medical papers, publications over 2000 – 2020, devoted to abdominal organ injuries, were analyzed. In the search engines PUBMED and eLibrary.ru, a selection of sources was made according to the keywords: “rupture of the mesenteric root of the small intestine,” “diagnostics,” “forensic medical evaluation.” The results of the literature analysis were used in the study of the repeated forensic medical examination materials of a case of rapid death (in 1.5 hours) due to a traumatic rupture of the mesentery of the small bowel and its large vessels. The combined analysis of the expert case report and special scientific literature allows us to devise the following conclusions: 1. A forensic expert must have expert knowledge in the normal anatomy of the abdominal aorta’s unpaired vessels and their accompanying veins location and know about their variable topographic and anatomical features. 2. Life-threatening bleeding from the damaged vessel of the mesentery of the small bowel occurs in a wide time interval after the mechanical damage. 3. The development of life-threatening intra-abdominal bleeding is due to the scope of damage and the rate of blood flow from the damaged vessel. 4. Thorough examination of the area of rupture of the mesenteric vessel and the state of the tissues in the circumference of the rupture allow to establish the mechanism of injury. 5. Ignorance of the mechanism of injury and specifics of the formation of injuries is the cause of expert errors and scientifically unfounded conclusions. 6. There is no reference material on the rate of blood flow from a damaged large vessel.

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Armstrong, Peter J., and David P. Franklin. "Superior Mesenteric Artery Branch Aneurysm with Absence of the Celiac Trunk." Vascular 14, no. 2 (April 2006): 109–12. http://dx.doi.org/10.2310/6670.2006.00015.

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Superior mesenteric artery and pancreaticoduodenal artery aneurysms are rare. Agenesis of the celiac axis has only been reported four times. The reported etiologies of superior mesenteric artery and branch artery aneurysms include infection, atherosclerosis, inflammatory processes such as pancreatitis, dissection, collagen vascular disorders, polyarteritis nodosa, and trauma. We report an aneurysm of the superior mesenteric artery (SMA) branch, the inferior pancreaticoduodenal artery, arising in a patient with congenital absence of the celiac trunk. The patient presented with intermittent left upper quadrant pain without weight loss or change in bowel habits. The aneurysm was identified on abdominal computed tomography scan with angiographic confirmation of the aberrant anatomy. The patient was treated by aneurysmectomy and pancreaticoduodenal artery reconstruction with an interposition vein graft from the SMA. The patient recovered without complications and is asymptomatic with a patent vein graft 2 years after operation.

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Slavu, Iulian, Adrian Tulin, Dan Păduraru, Bogdan Socea, Vlad Braga, Octavian Enciu, and Lucian Alecu. "Trauma of the mesentery. Anatomy and diagnosis." Romanian Journal of Orthopaedic Surgery and Traumatology 3, no. 1 (June 1, 2020): 64–69. http://dx.doi.org/10.2478/rojost-2020-0010.

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AbstractMesenteric lesions in abdominal trauma are encountered in 3% of the cases. Diagnosis of these lesions is difficult, which translates into important delays until surgery that affects patient survival. The short-term consequences of mesenteric lesions translate in bowel ischemia or important blood loss. If a lesion is confirmed after imagistic investigations, one must have complete knowledge of the anatomy and the particular distribution of the main arterial and venous trunks to predict the region of the small bowel that will have to be observed or resected if surgery is required. The aim of our study was to demonstrate this particular distribution of blood vessels through cadaver dissection and to note the resources available to diagnose such lesions.

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Tarasenko, S. V., A. A. Natalsky, O. D. Peskov, S. N. Sokolova, T. S. Rakhmaev, I. V. Bakonina, A. Yu Bogomolov, and D. A. Glotov. "Comparison of access to the superior mesenteric arteryduring the execution of the pancreatoduodenal resectionin patients with borderline-resectable cancer of the pancreatic head." Experimental and Clinical Gastroenterology, no. 10 (January 18, 2023): 97–102. http://dx.doi.org/10.31146/1682-8658-ecg-206-10-97-102.

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The purpose of the study is to study the technical aspects of surgical treatment of borderline-resectable pancreatic head tumors Materials and methods. An analysis of the implementation of the DA was performed in 102 patients with borderline-resectable pancreatic head cancer. In 20% of patients, the tumor grows in the region of the celiac-mesenteric gap of the tumor (mesopancreas germination). In 25.6%, the tumor grows on the wall of the portal-superior mesenteric segment. In 12.7%, the tumor tightly covers the walls of the branches of the celiac trunk or superior mesenteric artery by less than 180 degrees, extending to the fascial sheath and adventitia of the vessel. Results. During the implementation of the DA with various methods of access to the IWL, no significant differences were revealed in the early postoperative period. Conclusion. The choice of access is determined by the “anatomy” of the spread of the tumor. AMS rear access is most convenient for IPDA isolation and ligation. Mesenteric access allows the most secure ligation of PDJV

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Leke, Michael A., Douglas B. Hood, Vincent L. Rowe, Steven G. Katz, Roy D. Kohl, and Fred A. Weaver. "Technical Consideration in the Management of Chronic Mesenteric Ischemia." American Surgeon 68, no. 12 (December 2002): 1088–92. http://dx.doi.org/10.1177/000313480206801213.

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Our aging population may result in a rise in the prevalence of chronic mesenteric ischemia. This report reviews our contemporary experience with a tailored surgical approach to chronic mesenteric ischemia. The medical records of 17 patients operated on for chronic mesenteric ischemia were retrospectively reviewed. Symptom-free survival and long-term patency documented by duplex scanning when available were also analyzed. Sixteen patients ranging in age from 32 to 80 years were included in the study. Seventy-five per cent of the patients were female. The most common preoperative complaints were postprandial abdominal pain and weight loss. Revascularization was tailored to the arterial anatomy and included bypass to the superior mesenteric artery (SMA) alone (eight), bypass to the celiac artery and SMA (six), SMA reimplantation onto the aorta (one), SMA/inferior mesenteric artery reimplantation (one), and transaortic endarterectomy of the celiac artery/SMA (one). Bypass conduits included Dacron (eight), saphenous vein (four), and polytetrafluoroethylene (two). Bypass grafts originated from the supraceliac aorta in 12 patients; the remaining bypass originated from the left limb of an aortofemoral graft. There was one perioperative death (mortality 5.6%). Follow-up duplex scans at a mean of 34 months (range 1–114) showed no graft thromboses. We conclude that a variety of surgical techniques can provide durable relief of mesenteric ischemia. A tailored approach to revascularization optimizes patency and provides long-term symptom-free survival.

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Sehgal, R., and J. C. Coffey. "Historical development of mesenteric anatomy provides a universally applicable anatomic paradigm for complete/total mesocolic excision." Gastroenterology Report 2, no. 4 (July 16, 2014): 245–50. http://dx.doi.org/10.1093/gastro/gou046.

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Journal articles on the topic 'Mesenteric anatomy'

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