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PubMed1982

Pneumatosis intestinalis and pneumoperitoneum due to a solitary sigmoid diverticulum.

A man aged 75 developed abdominal pain during treatment with steroids for periarteritis nodosa. Laparotomy disclosed air in the peritoneum, and a section of the sigmoid colon contained numerous airfilled cysts and the mesocolon was emphysematic. A solitary diverticulum communicated with a fistula extending into the mesocolon. Neither inflammation, nor other diverticula were seen at the histological examination.

Aged↗

PubMed1994

[Characteristics of the surgical treatment of total duodenal atresia].

The authors analysed the results of surgical management of total duodenal atresia in 12 newborns. In 10 of them the operation was successful. Duodenojejunoanastomosis on a short jejunal loop was formed through a window in the mesocolon in all patients. The success of the treatment is determined by careful performance of all the details of the surgical intervention. Of particular importance are such elements of the operation as the formation of the spur from the afferent genu of the jejunum and fixation of the anterior duodenal wall in the window in the mesocolon. It is preferable to create the anastomosis with a single row of interrupted sutures of synthetic atraumatic material 5/0-6/0 with the knots in the intestinal lumen.

Anastomosis, Surgical↗

PubMed1994

Mesenteric cysts in children.

BACKGROUND: Mesenteric cysts are uncommon benign abdominal masses. Approximately one third of patients with these lesions are children. METHODS: We reviewed our clinical records for the past 14 years (corresponding to the period of time in which ultrasonography and computed tomography became reliable methods for imaging pediatric patients) and found 10 patients with mesenteric cysts. RESULTS: We were surprised to discover that abdominal pain was a presenting complaint in all but one patient. Five of the patients had the findings of an acute surgical abdomen and were thought to have appendicitis. Two patients operated on for appendicitis were transferred to our hospital with the diagnosis of an abdominal mass. In each case the mass was a mesenteric cyst. Cyst distribution included the small-bowel mesentery in seven patients, the transverse mesocolon in two patients, and the right mesocolon in one patient. Six cases required concomitant bowel resection for the cyst removal, and all were cystic lymphangiomas. The resected specimens were described as cystic lymphangiomas in eight of the 10 cases. CONCLUSIONS: Mesenteric cysts should be considered as an origin for abdominal pain in children, particularly after exclusion of more common diagnoses. We have found ultrasonographic imaging to be a reliable method for the diagnosis of appendicitis in children and advocate its use as an initial imaging study in patients with an acute surgical abdomen and presumed appendicitis. If appendicitis is indicated unlikely by ultrasonogram, the examination can be extended to the remainder of the abdomen, which can reveal mesenteric cysts or other pathologic conditions.

Adolescent↗

PubMed1977

[Neurotrophic interaction of spinal cord ganglia with different tissues].

Spinal ganglia L5-L6 together with mesocolon (innervated from these ganlia) and tongue epithelium were transplanted into the anterior chamber of the cat eye. In 2 months survival of some of the sensory neurons and intensive regeneration of their nerve fibers was observed. At the same time the mesocolon tissues with the mechanoreceptors (Pacinian corpuscles) were found to survive. Destruction of the tongue epithelium was revealed. The trophic effect of definite sensory ganglia on the tissue corresponding to them provided structural intactness of this tissue and of its receptor apparatus. It is suggested that the metabolic conformity of the tissue and the source of its innervation is necessary for the tissue survival.

Animals↗

PubMed1997

[Special surgery of blood vessels injuries in abdominal trauma].

The analysis of the results of treatment of 41 victims with large vessels injuries in abdominal trauma was carried out. According to their location, all the injured vessels were divided in 5 groups: 1) on median line above the mesocolon (9 cases); 2) on median line under the mesocolon (14 cases); 3) in superior lateral part of the abdominal cavity (2); 4) in interior-lateral part of abdominal cavity (8); 5) in the region of hepato-duodenal ligament and retrohepatic area (13). Combined vascular injuries were observed in 5 patients. Basic aspects of diagnosis, surgical policy and treatment are discussed, 14 patients died.

Abdomen↗

PubMed1998

[Malignant melanoma of soft parts (clear cell sarcoma)--a rare case of multiorgan localization].

Malignant melanoma of soft parts (MMSP) is a rare tumor originally described by Enzinger in 1965 as clear cell sarcoma of tendons and aponeuroses because of its affinity to tenosynovial structures. Tumors are found predominantly at the extremities. First visceral case was described in 1993 in the duodenum. We describe the case of 64-years old man with malignant melanoma of soft parts in the stomach, in the pancreas, in the mesocolon, in the left thigh and in the left axilla. This patient was successfully treated surgically by the resection of the stomach, resection of the pancreatic head, extirpation of the tumor from mesocolon, from the left thigh and from the left axilla. In all these localisations the tumor was histologically and imunohistochemically proved to be MMSP (positivity: s-100 protein, vimentin, HMB-45 and negativity CK, EMA, desmin, actin). This multivisceral occurrence is extremely rare and according to the review of literature this is probably the first published case of MMSP in the stomach and in the pancreas.

Axilla↗

PubMed1992

Abdominal inflammatory myofibroblastic tumours in children.

Inflammatory myofibroblastic tumours (inflammatory pseudotumours) occurring at intra-abdominal sites in children have rarely been described. This paper reports three patients with this tumour, two of whom presented with fever, anaemia and an abdominal mass, the third with chronic duodenal obstruction. All had experienced significant weight loss. At operation, each had a large fibrous tumour (7-18 cm in diameter) originating from the transverse mesocolon, small bowel mesentery and duodenum respectively. Intraoperative frozen section histological examination in one patient was misinterpreted as a sarcoma. All the lesions were judged to have been completely excised, but one was ruptured during operation and the patient subsequently developed recurrent tumour nodules. Abdominal inflammatory myofibroblastic tumours are rare. They may be suspected before operation but their clinical, radiological and pathological features may be confused with those of malignancy. Complete excision is necessary to avoid local recurrence.

Child↗

PubMed1996

Extraperitonealization of the anastomosis and sacral drain in restorative surgery for rectal carcinoma: a safety mechanism in the absence of a covering stoma.

A retrospective 10-year study was conducted on 473 patients who underwent rectal cancer surgery, to evaluate a surgical procedure which has been generally abandoned, but which we believe has a significant potential to reduce the incidence of the severe and often fatal complications caused by anastomotic breakdown following low anterior resection, especially when a covering stoma is absent. This procedure involves separating the anastomosis and sacral drain from the abdominal cavity by suturing the parietal peritoneum to the colon and mesocolon, and placing the sacral drain outside the peritoneal cavity, whereby contamination of the abdominal cavity is avoided should anastomostic leakage occur. Sphincter preservation was possible in 343 patients (72.5%) while 116 (24.5%) underwent abdominoperineal resection (APR). Of 331 patients who underwent sphincter-saving resection (SSR), 31 (9.4%) had primary protective colostomies. Radical RO-resection according to the International Union Against Cancer (UICC) was performed in 405 patients, and 65 (19.6%) underwent extended resections. Anastomotic leakage became clinically manifest in 33 patients (10%; or 11% when those with primary colostomies were excluded). Only 1 patient required relaparotomy while 32 were successfully treated with temporary loop colostomy in the right epigastrium. No deaths occurred following anastomotic leakage breakdown. Overall operative hospital mortality was 3.0%; 2.7% and 2.6% in the SSR and APR groups, respectively. The adjusted 5-year survival rates were 60% for APR and 72% for SSR.

Aged↗

PubMed1977

Congenital positional anomalies of the colon: radiographic diagnosis and clinical implications. II. Abnormalities of fixation.

Defective fixation during embryologic development is responsible for a variety of segmental colonic malpositions seen during barium enema examinations. A review of the normal development process of fixation is presented, together with the most common and significant aberrations. On the right side clinical entities such as axial torsion, cecal bascule, retrocolic sigmoid, and pericolic bands are discussed and illustrated. On the left side, the configuration and clinical implications of the malposition of the splenic flexure are analyzed. It is pointed out that reversed configurations of the splenic flexure associated with failure of fixation of the entire descending colon may occur as an isolated congenital abnormality and may not necessarily be associated with renal anomalies. The characteristic radiographic appearance of the persistent descending mesocolon and its potential for complications is in addition emphasized. Familiarization with the radiographic appearance and clinical implications of these common abnormalities is essential in the daily interpretation of barium enema examinations.

Aged↗

PubMedDate not supplied

Computed tomographic appearance of sigmoid volvulus.

The computed tomographic (CT) appearance of two cases of sigmoid colon volvulus is described. Both underwent plain abdominal radiographs, contrast enema, and CT. The findings of sigmoid volvulus at CT were characteristic, having a whirl pattern of the dilated sigmoid loop around mesocolon and vessels and a bird-beak aspect of the afferent and efferent segments. CT may be valuable in a case of unusual clinical or plain film presentation as an alternative to contrast enema.

Aged↗

PubMed1998

Gastrocolic vein. Definition and report of two cases of avulsion.

The gastrocolic v. or Henle's gastrocolic trunk was described in 1868 [9]. We suggest defining this vein as the confluence of the right gastroepiploic and right upper colic vv. We report two original cases of avulsion of the gastrocolic v. occurring during a blunt abdominal trauma. The aim of this paper is a description, based on the literature, of the anatomy of the gastrocolic v. in order to precise the lesional mechanism. The gastrocolic v. is present in 70% of individuals. It is short (less than 25 mm) but of major calibre (3 to 10 mm). The gastrocolic v. is situated close beneath the root of the transverse mesocolon, and travels along the anterior surface of the head of the pancreas. Anatomic variations are detailed and a meta-analysis of interpretable studies was made. Both the supra- and infra-mesocolic surgical approaches are described. The radiologic and surgical importance of the gastrocolic v. is discussed. The lesional mechanism in both our cases of injury of the gastrocolic v. is explained.

Abdominal Injuries↗

PubMed2000

Hydatid disease in children may have an atypical presentation.

Although there is voluminous literature describing various aspects of hydatid disease in children, little attention has been paid to the small group of patients whose symptoms result in atypical presentation. This article addresses this problem, describing the features in ten children aged from 2 to 12 years. The sites of involvement were within a choledochal cyst (1). the pelvic cavity (1), the spleen (1), and transverse mesocolon. Albendazole was efficacious in the treatment of one recurrent case, as well as in preventing recurrence.

Adolescent↗

PubMed2002

Forces and displacements in colon surgery.

BACKGROUND: This study aims to find criteria for designing safer laparoscopic graspers for manipulation of delicate tissues. Since the experiment was performed in an open-surgery setup without any movement restrictions, the results are relevant to general surgery as well as laparoscopic. METHOD: Four surgeons were asked to apply via two clamps enough force to a pig's colon to stretch the mesocolon for dissection. Directions, magnitudes, and application points of the forces were recorded. RESULTS: The surgeons applied per clamp on average 2.5 N and maximally 5 N to the colon. These forces were at an angle of about 40 degrees to 70 degrees relative to the horizontal plane and approximately 60 degrees relative to each other. CONCLUSIONS: Safe laparoscopic graspers should be able to transmit at least a 5 N pull force to the tissue without damaging it. To minimize the forces used, the angles mentioned should be taken into account when placing the trocars.

Animals↗

PubMed1979

Anatomic correlations in radiogallium imaging of the peritoneum and retroperitoneum.

Radiogallium (67Ga) imaging of the abdomen and pelvis has been useful not only in detecting inflammations in these regions, but in pointing out their precise anatomic localization. Once the anatomic site is determined, it is often possible to infer the source of origin of the problem (such as ruptured viscus or pancreatitis). Interpretation of the images depends on recognition of patterns that define known anatomic boundaries such as the transverse mesocolon, root of the small mesentery, perirenal space, and pararenal space, or else show diffuse peritoneal uptake. The anatomic patterns may have continued usefulness in future studies, such as when radiolabeled leukocytes are employed to localize inflammations.

Abdomen↗

PubMed1974

Role of the sympathetic innervation of the pacinian corpuscle.

An investigation was made into the nature of the role played by the noradrenergic innervation of the pacinian corpuscle. Corpuscles of the cat mesentery and mesocolon were used in all experiments. Blockade of noradrenergic beta receptors by dichloroisoproterenol and interference with norepinephrine release by reserpine are each capable of reversibly blocking mechanoelectric transduction by the pacinian corpuscle. The monoamine oxidase inhibitors iproniazid and phenelzine are capable of protecting the transducer from the blocking effects of reserpine. It is concluded that the presence of norepinephrine, as maintained by sympathetic tonus, is required for the afferent nerve terminal of the pacinian corpuscle to be mechanosensitive.

Animals↗

PubMed1992

Delayed gastric emptying after Roux-en-Y due to four types of partial obstruction.

Partial obstruction was the cause of delayed gastric emptying in 12 patients after a Roux-en-Y gastrojejunostomy in a consecutive personal series of 42 patients between 1975 and 1989. Four types of obstruction were identified. Type I was due to a kinked loop of jejunum where it passed through the mesocolon. Type II had the anastomosis too high on the gastric pouch, type III was due to an obstructing marginal ulcer, and type IV had a pouchlike deformity develop in the upper jejunum at the anastomosis that gradually compressed the outflow tract. No patient had stenosis of the anastomosis. The upper gastrointestinal (GI) series plus nuclear studies of the liquid and solid phase gastric emptying provided evidence of the presence and degree of delayed gastric emptying but not the site or cause of the obstruction. Upper GI endoscopy provided precise evidence of the site of the partial obstruction, its anatomic nature, and the presence of a bezoar or marginal ulcer. Of the 42 patients, 4 had surgical correction, and in 6 patients the obstruction was relieved by endoscopic manipulation; all patients have been relieved of their symptoms. Partial obstruction was the only cause of delayed gastric emptying in this series, and contrary to recent reports, no patient required a total or near total gastrectomy.

Adult↗

PubMed1990

Mesenteric hernias through defects of the mesosigmoid.

Internal herniation through defects in the gastrointestinal mesentery is extremely rare. Two patients with small bowel herniation involving the sigmoid mesocolon are reported. The condition has a high incidence of strangulation, with rapid onset of gangrene of the bowel. The mortality is high and the role of early surgical intervention is stressed.

Adolescent↗

PubMed1992

Volvulus of the colon in a horse associated with a mesocolic-umbilical band.

A 7-years-old Clydesdale mare was presented with severe abdominal distension and acute colic. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed. A 180 degrees volvulus of the pelvic flexure was present, associated with an inelastic band of tissue connecting the mesocolon to the umbilicus. The band was ligated and transected, and the volvulus reduced. Postoperative complications included hyponatraemia, metabolic acidosis and laminitis. The possible aetiology of the mesocolic-umbilical band is discussed.

Animals↗