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PubMed2003

Segmental misty mesentery: analysis of CT features and primary causes.

PURPOSE: To review the computed tomographic (CT) features of segmental misty mesentery (SMM) in 29 patients and assess the primary causes of this CT finding. MATERIALS AND METHODS: The authors analyzed the medical records and CT features of SMM in 29 patients. CT images were evaluated for the site, thickness, and vascular changes of the involved mesentery; bowel wall changes; lymphadenopathy; and the fat ring sign. The primary cause of SMM in five patients was determined at histopathologic examination, that in three patients was determined at surgical observation of the mesentery, and that in nine patients was determined on the basis of follow-up CT and clinical data. The primary cause of SMM in 12 patients was unknown. RESULTS: Twenty-five of the 29 patients had various underlying diseases. Fourteen (48%) patients had a malignancy: 11 had intraabdominal cancer and three had extraabdominal cancer. Jejunal mesentery was more commonly involved than was ileal mesentery (P <.05). The mean thickness of the SMM was 4.0 cm. Mesenteric vessels were dilated in 27 patients (93%): 19 with venous dilatation and eight with either arterial dilatation only or both arterial and venous dilatation. At CT, seven (24%) patients had a thickened bowel wall; nine (31%) patients, lymphadenopathy; and two (7%) patients, the fat ring sign. The primary cause of SMM was edema in eight, malignant neoplasm in four, inflammation and/or fibrosis in five, and idiopathic in 12 patients. CONCLUSION: At CT, SMM appears as a result of malignant neoplasms, inflammation, or vascular disorders.

Adolescent↗
PubMed1977

Quantitative studies of microcirculatory structure and function. III. Microvascular hemodynamics of cat mesentery and rabbit omentum.

We made simultaneous measurements of intravascular pressure and red blood cell velocity for vessels which make up the modular configuration of microvascular networks in mesentery and omentum. An analysis of these variables and the computed volumetric flow rates is presented for arterioles which had a maximum diameter of 56 micrometer through the "true capillaries" (typically 7 micrometer for mesentery and 8 micrometer for omentum) to 56-micrometer venules. The spatial variance of pressure and flow is related to topographical features of each network. Vascularization statistics for each network are presented and demonstrate a unique ratio of potential microvascular exchange area to module planar area, with values of 0.71 +/- 0.22 (SD) for omentum and 0.19 "/- 0.03 (SD) for mesentery. Analysis of the volumetric flow rate for each module demonstrates a linear relationship to the planar area of tissue serviced by each modular network. In situ perfusion rates of 1180 ml/min per 100 g and 105 ml/min per 100 g were determined for omentum and mesentery, respectively. The hemodynamic resistance of the omental and mesenteric circuitry was evaluated, and in the case of the omentum, found to be inversely proportional to the planar area of the module. The arterial to venous distribution of pressure and flow for the mosaic of contiguous modules in omentum and mesentery is described and related to the deployment of parallel and serial microvessels of each network.

Animals↗
PubMedDate not supplied

The mesentery as a laminated vascular bed for hepatocyte transplantation.

The small bowel mesentery provides a unique structure of a large vascularized surface area to support hepatocyte transplantation. Cell-seeded polymeric matrices can be juxtaposed in a relatively atraumatic manner between leaves of mesentery such that adequate exchange of nutrients and diffusion of gases can proceed in the interim while neovascularization occurs. Hepatocytes obtained from (RHA) Wistar rats by collagenase perfusion were seeded onto non-woven filamentous sheets of polyglycolic acid 1 x 3 cm in size and 2 mm thickness to a density of 500,000 cells/cm2. Twenty-six recipient Gunn rats (UDP-glucuronyl transferase deficient) underwent laparotomy. Hepatocyte-ladened polymer sheets were placed between leaves of mesentery. Eight sheets were placed per animal and the leaves were approximated, creating a functional implant 1 x 3 x 2 cm. Biopsies between 5-99 days after implantation revealed neovascularization, moderate inflammatory reaction and the presence of viable hepatocytes in 96% (25/26). Immunoperoxidase studies using anti-albumin antibody substantiated hepatocyte specific function in implants. HPLC profiles of bile from Gunn rats transplanted with hepatocytes from congeneic (RHA) rats demonstrated the presence of bilirubin conjugates. There were no conjugation fractions seen in control gunn rats without hepatocyte transplantation. Although total serum bilirubin did not significantly decrease, conjugated bilirubin was identified in 46% (12/26) animals after transplantation with congeneic hepatocytes. We conclude that the mesentery of the small bowel provides a large vascularized surface for cell transplantation. Large numbers of metabolically active hepatocytes can engraft, vascularize, and show function. The mesentery may be a potential bed for clinical hepatocyte transplantation.

Animals↗
PubMed1987

Morphological aspects and observations about the permeability of the rat mesentery to the osmium-amine.

In a previous work we felt that many authors were interested in observing the permeability and structure of the mesentery employing many techniques and analysing the material from different points of view. Our collaboration, at that time, was limited to the study of the permeability of the mesentery to the lanthanum nitrate and we came to a final conclusion that the penetration of the heavy salt is impeded by the presence of a basement membrane, localized between the mesothelial and connective tissue layers and that it was continuous to the basal lamina, located between neighbouring mesothelial cells; we could then observe that the lanthanum traveled through the cytoplasm and not in between mesothelial cells. In this paper we analyze the behavior of the mesentery in relation to the osmium-amine and we compare it to the observations made in our previous work. Generally speaking, we were unable to observe any reaction in any of the structures of the mesentery, except for some special cases. In those not very common cases, employing special techniques, we came to the conclusion that the osmium-amine reacts in the periphery (outer surface) of the mesentery and also penetrates, sometimes with no visible reaction, all the way to the elastic layer, where a reaction can be detected.

Amines↗
PubMed1988

Interaction of B16 malignant melanoma tumor cells with the murine mesentery in vitro.

We have used organs cultures of murine mesentery as a model system to investigate the mechanisms by which B16-F10 melanoma cells invade normal tissues. The mesentery has the advantage of being a real tissue, consisting of a loose connective tissue, containing a normal complement of stromal cells and extracellular matrix, covered by a continuous epithelium of squamous mesothelial cells which are separated from the connective tissue by a laminin-containing basement membrane. B16-F10 cells seeded onto the mesentery in vitro cause a local retraction of the mesothelial cells exposing the underlying basement membrane onto which the tumor cells spread. Direct contact between the tumor cells and the margins of the mesothelial cells is required to induce retraction. Most of the B16 cells remain on the surface of the mesentery where they spread on the basement membrane without disrupting it. A few B16 cells penetrate the basement membrane and invade the connective tissue interior of the mesentery where they flatten out and assume a fibroblastic morphology. Tumor cells within the connective tissue may continue to translocate and they adhere to and move along the fibers of the connective tissue extracellular matrix without appearing to destroy or disrupt them.

Animals↗
PubMed1988

Elevated ambient oxygen does not affect autoregulation in cat mesentery.

The purpose of this study was to determine whether oxygen plays a role in the autoregulation of blood flow in the isolated mesentery of the cat. Arteriolar diameter and red cell velocity were measured at normal arterial pressure and during 2 min of pressure reduction to 80 and 40 mmHg under ambient levels of 0, 10, and 20% oxygen in nitrogen. Autoregulatory responses during pressure reductions to 80 and 40 mmHg were not significantly different under 0% oxygen compared with those under 10 or 20% oxygen. Also, no significant difference was found in the control state between the mean diameters, linear velocities, or volume flows under 10 and 20% oxygen compared with 0% oxygen. We also determined oxygen levels just under the mesentery with different ambient oxygen levels. These values were the same as in the ambient gas mixture, suggesting that tissue oxygen levels in mesentery are determined by those in the external environment. Oxygen levels in the abdominal cavity averaged 67 mmHg, indicating that mesentery is normally exposed to a high-oxygen environment. We conclude that a change in tissue oxygen tension is not an essential factor in the mechanism of blood flow autoregulation in cat mesentery.

Animals↗
PubMed1988

Role of leukotrienes in vascular changes in the rat mesentery and skin in anaphylaxis.

The role of leukotrienes and other mediators of vascular changes in anaphylaxis were studied in rats sensitized with monoclonal anti-DNP IgE and challenged with DNP-BSA. Microvascular changes in the mesentery were followed by intravital fluorescent microscopy and in the skin by exudation of Evans blue dye. Administration of Ag i.v. caused a marked increase in the peristaltic movement of the intestine, plasma exudation, and arteriolar constriction in the mesentery. The microvascular changes were accompanied by a profound fall in blood pressure, which was biphasic. The first phase lasted for approximately 2 min. The second phase was very prolonged and the hypotension was still maintained 40 min after Ag challenge. The changes observed were dose dependent with regard to Ag. Intradermal application of Ag resulted in dose-dependent extravasation of Evans blue dye in the skin. Plasma exudation was partially inhibited by pyrilamine and methysergide. However, their effect seemed to be more pronounced in the skin than in the mesentery. The leukotriene D4-R antagonist L-649,923 and the 5-lipoxygenase inhibitor ONO-LP-049, alone or in combination with other inhibitors, did not alter the plasma leakage in the skin. In the mesentery, the leukotriene antagonists alone had a moderate effect on vascular permeability. However, the combination of these agents with pyrilamine completely inhibited macromolecular extravasation. The hypotension was modulated by the antihistamines as well as the leukotriene and serotonin antagonists. Pyrilamine inhibited the first phase and the second phase. The major effect of methysergide was a decrease in the duration of the hypotension. This was especially evident when it was administered in combination with other inhibitors. The leukotriene antagonists when given alone had moderate effects on the blood pressure changes. However, in combination with pyrilamine, the hypotension was substantially reduced. Leukotrienes appeared to be important mediators of the vascular changes in the mesentery but not in the skin (passive cutaneous anaphylaxis). They markedly potentiated the action of histamines.

Animals↗
PubMed1996

The perforated mesentery of the rat: a novel model for the study of genuine connective tissue contraction.

The rat and mouse mesenteries consist of an array of thin, mesenchymally derived, connective tissue membranes. Perforations of rat membranes heal by closure within a week and the perforated rat mesentery has earlier been shown to be a very suitable model of true connective tissue repair. In the present study, the closure of perforations in the rat was studied by light and transmission electron microscopy as well as confocal microscopy after actin staining with phallacidin in order to better understand the cellular mechanisms of healing in this model. The healing of different sized mesenteric perforations was also quantitatively assessed and compared in rats and mice. Closure occurred rapidly between Days 5 and 7 in rats, the velocity of healing being dependent on the size of the wounds. During closure, fibroblasts close to the wound margin ultrastructurally showed long slender cytoplasmic processes that contained actin filaments as shown by fluorescence confocal microscopy. In mice, larger perforations of mesenteries decreased in size during the 3-week observation period, but very seldom closed completely. In conclusion, the data gathered now and earlier indicate that a contraction phenomenon is of major importance in the closure of rat mesenteric perforations. Until now, good models for genuine connective tissue contraction have been lacking and it is suggested that the perforated rat mesentery may be used as such a model system in the future. The finding that mouse mesenteric perforations normally do not heal will make comparative studies intriguing, but it also indicates basic differences between rats and mice with respect to connective tissue repair mechanisms.

Actins↗
PubMed1984

Cathepsin B containing cells in the rabbit mesentery during invasion of V2 carcinoma cells.

Localization of cathepsin B was studied in the rabbit mesentery during invasion of V2 carcinoma cells. Cathepsin B was visualized immunohistochemically by using monospecific sheep antibodies and the avidin-biotin-peroxidase complex (ABC) method. Horizontal and vertical semithin Epon embedded sections of stained mesenteries showed that histiocytes always displayed the strongest staining reaction independently of the presence of V2 carcinoma cells. Fibroblasts, mesothelial cells and the invaded V2 cells were less stained. Strongly stained peritoneal monocytes were frequently found on the surface of the mesentery in association with tumor foxi. The role of these various cathepsin B containing cells with respect to extracellular matrix degradation during tumor invasion in the mesentery is not clear; some aspects of this problem are presented in the discussion.

Animals↗
PubMed1988

Atropine and hexamethonium-sensitive, Ca/K-modulated, reversible swelling of mast cells in rat mesentery, due to feeding or exposure to carbachol.

Transitory swelling of mesenteric mast cells was observed when 24 h-fasted rats were given access to food. Atropine, an anti-muscarinic drug given (1 mg/kg, i.p.) 60 min prior to feeding, prevented this response; carbachol, a cholinomimetic drug caused it to occur when given (2 micrograms/kg, i.v., 10 min) to fasted rats. Mast cells in the mesentery excised from fasted rats, presented swelling in vitro within 1 min following exposure to 10(-7) M carbachol. This response was inhibited by atropine (10(-8) M) or hexamethonium (10(-8) M), indicating that stimulation of a parasympathetic nerve pathway, reported to exist in rat mesentery, could induce mast cell swelling. Exposure to a Ca2+ free medium also led to rapid swelling of mast cells in the mesentery excised from fasted rats. This result, as well as inhibition of the mast cell response to carbachol caused by increasing the Ca2+ (but not by increasing the Mg2+) content of the incubation medium, suggests that swelling was caused by a sudden decrease of Ca at mast cell membrane sites controlling ion/water fluxes. Mast cells swollen by feeding, carbachol or Ca-lack, reverted to their original condition within 20 min when incubated in balanced salt buffer. Such reversal did not occur in a KCl-enriched medium. An equivalent (in terms of ionic strength), increase in NaCl, did not reproduce this effect, indicating that mast cells have K+-dependent means of compensating for endogenously or drug-induced volume changes. Swelling caused by cholinergic stimulation of mast cells was not accompanied by granule exocytosis.2+ carbachol-treated rat blood in vivo or in vitro, is discussed in terms of putative mast cell-controlled, localized homeostasis in the rat mesentery.

Animals↗
PubMed1998

Lymphangioma of the jejunum and mesentery presenting with acute abdomen in an adult.

We describe a patient, 54-year-old woman, with lymphangiomas of the jejunum and mesentery presenting as acute abdomen. She had sudden onset of severe abdominal pain with guarding and fever. Physical examination revealed an elastic hard mass, with marked tenderness in the right abdominal region. Ultrasonography and computed tomography revealed a heterogenous mass, 20 x 15 x 8cm in size, in the mesentery. An emergency operation was performed with the diagnosis of diffuse peritonitis due to an inflammatory tumor in the mesentery. At operation, the tumor was found in the mesentery, adhering to a 60-cm segment of the jejunum. Multiple small tumors were seen in the submucosal layer of jejunum. The tumor was excised with a 60cm length of the jejunum. Histologically, the tumors were diagnosed as cavernous lymphangiomas. Although lymphangioma in the abdomen is rare in adults, we should consider it as one of the causes of acute abdomen.

Abdomen, Acute↗
PubMed1978

The role of various prostaglandins on the correlation between permeability to albumin and cAMP levels in the isolated mesentery.

Prostaglandins (PG) have been shown to raise the level of cyclic AMP (cAMP) in various tissues, and to increase permeability. Whether both events are linked, is at present a matter of speculation. We have investigated the effects of PGE1, E2, A1, A2, F1alpha and F2alpha on an isolated rat mesentery placed in a diffusion cell (surface area : 2 sq.cm). The PGs (5 microgram/ml) increased the passage of (I 125) - Albumin across the mesentery. In other experiments, diks of rat mesentery (surface area : 2 sq.cm) have been incubated in assay tubes, and cAMP levels measured by a binding protein assay. We have observed an excellent correlation between increases in permeability and cAMP levels (r=0.961). In order of increasing potency on both parameters, the PGs may be classified as follows : PGF, PGA and PGE. In the rat mesentery, under the influence of prostaglandins, increases in permeability and in cAMP levels are apparently connected.

Albumins↗
PubMed2006

Lengthening of small bowel mesentery: stepladder incision technique.

The surgical option of choice in most patients with mucosal ulcerative colitis or familial adenomatous polyposis is restorative proctocolectomy with ileal pouch anal anastomosis. The tension-free anastomosis is one of the most critical steps but may be technically difficult or impossible in some patients because of shortened small bowel mesentery. Various techniques have been described to increase the length of small bowel mesentery. These techniques usually involve selective division of mesenteric blood vessels and meticulous dissection. We describe a new technique of stepladder transverse, transmesenteric incisions in the avascular windows of small bowel mesentery. This provides additional small bowel length without compromising blood supply to the pouch and a simple and safe method of increasing the length of small bowel mesentery. To date, no complications have been reported using this technique.

Colonic Diseases↗
PubMed2006

Frequency and management of internal hernias after laparoscopic antecolic antegastric Roux-en-Y gastric bypass without division of the small bowel mesentery or closure of mesenteric defects: review of 1400 consecutive cases.

BACKGROUND: It is common practice to close mesenteric defects in abdominal surgery to prevent postoperative herniation and subsequent closed-loop obstruction. The aim of this study was to review our experience with antecolic antegastric laparoscopic Roux-en-Y gastric bypass (AA-LRYGBP) without division of the small bowel mesentery or closure of potential mesenteric defects. METHODS: Data for 1400 patients who underwent AA-LRYGBP between January 2001 and December 2004 was prospectively collected and retrospectively analyzed for the incidence of internal hernias. In all cases, an antecolic antegastric approach was performed without division of the small bowel mesentery or closure of potential hernia defects. RESULTS: Three patients (0.2%) developed a symptomatic internal hernia. Two of these patients had a 200-cm-long Roux limb, and the other had a 100-cm-long Roux limb. All three patients exhibited mild symptoms of partial small bowel obstruction. In all three cases the internal hernia was clinically manifested more than 10 months after the original AA- LRYGBP. Exploration revealed that the hernia site was between the transverse colon and the mesentery of the alimentary limb at the level of the jejunojejunostomy (Petersen's defect) in all three cases. All three patients underwent successful laparoscopic revision, hernia reduction, and mesenteric defect closure. CONCLUSIONS: AA-LRYGBP without division of the small bowel mesentery or closure of mesenteric defects does not result in an increased incidence of internal hernias. The laparoscopic approach for reexploration appears to be an effective and safe option.

Aged↗
PubMed1981

Cholinergic nerves in the mesentery.

The cholinergic innervation of extravascular portions of rat mesentery was studied in normal as well as 6-hydroxydopamine (7 OHDA) sympathectomized animals. We observed the presence of a cholinergic innervation unaltered by 6 OHDA treatment in extra-vascular portions of mesentery. Cholinergic nerve fibers coming from paravascular nerves forms loop]-like structures that innervate the mesentery proper. Also the islands of adipocytes of mesentery seem to be provided with a cholinergic innervation. The findings are discussed.

Adipose Tissue↗
PubMed1999

Traction on the mesentery as a model of visceral nociception.

Traction of the mesentery is known to induce strong autonomic reactions in patients undergoing abdominal surgery. An experimental model using this stimulus in anaesthetized rats has been developed, which allows the comparison of noxious mechanical and chemical stimulation of the mesentery. Graded traction on a bundle of jejunal vessels with 2-30 g led to reflex changes in blood pressure and intragastric pressure, the size of which correlated with the strength of the stimulus. Comparable responses were elicited by clamping the same vessels either at their distal or proximal end or by applying 100 microl 0.6% acetic acid or 0. microM bradykinin. These reflexes are fairly insensitive towards impairment of the autonomic system. Only the combination of phentolamine and propranolol reduced the cardiovascular responses to all stimuli but at the same time, significantly lowered basal blood pressure. The adrenoceptor antagonists affected the gastric response to acid only. Atropine on its own was ineffective. Administered together with the combination of adrenoceptor blockers it had no further influence on the cardiovascular reflexes but significantly reduced the gastric responses to stretch, proximal clamping and acid. Acute desensitization of small diameter afferents with capsaicin almost abolished the reflex responses to acid. The cardiovascular, but not the gastric, response to traction was reduced by capsaicin. Morphine led to dose-dependent reductions of the reflex responses in a naloxone-reversible manner, whereas indomethacin was inactive. The bradykinin B2-antagonist icatibant abolished the reflex in response to the application of bradykinin but not to acid or traction. It is concluded that the measurement of the cardiovascular and gastric responses of anaesthetized rats to traction on the mesentery is a suitable method to investigate acute visceral nociception. Chemical stimuli to the mesentery are transmitted by capsaicin-sensitive afferents, but there is a dichotomy regarding capsaicin's influence on visceral mechanonociception. Opioid mechanisms are always involved, whereas prostaglandins or bradykinin have no role in the reflexes evoked by acid or traction. Intact alpha- or beta-adrenergic (as tested with unselective receptor antagonists) or muscarinic mechanisms are required for the reaction of the end organs in the reflex but they have no role in the afferent or central processing.

Anesthesia↗
PubMed1983

Hyperplasia and growth of the true mesentery in the diabetic rat.

The true mesentery was studied in rats 4 weeks after they had been rendered diabetic with streptozotocin. The diabetic animals showed elongation and enlargement of the small intestine despite reduced body growth compared with controls of the same age. The mesentery in diabetic animals showed increased total area and contained an increased number of "windows", but the increment of total protein, DNA, and histamine (a marker of mast cells) was non-uniform and less than the increase in area. There appeared to be a close relationship between hyperplasia of the small intestine and its mesentery. The number of mast cells yielded by peritoneal lavage was increased in the diabetics. We suggest that our observation of the hyperplastic mesenteric reaction in diabetic rats may make a useful model for the study of growth, profiferation, and function of the mesentery available.

Animals↗
PubMed1976

Osmotic reflextion coefficients of capillary walls to low molecular weight hydrophilic solutes measured in single perfused capillaries of the frog mesentery.

1. Individual capillaries of the transilluminated frog mesentery have been perfused with suspensions of human red cells in frog Ringer solution containing 1-0 g albumin 100 ml.-1. The outer surface of the mesentery has been washed with normal frog Ringer solution and with frog Ringer solutions made hypertonic by addition of one of the following solutes: sodium chloride (100 m-mole. 1.-1); urea (100 m-mole.1.-1); sucrose (20-50 m-mole. 1.-1); cyanocobalamin (8-5 m-mole. 1.-1). The temperature of the mesentery was between 14 and 16 degrees C in all experiments. 2. Wtih the mesentery superfused with normal Ringer, the filtration coefficient was determined from measurements of the rate of fluid filtration across the capillary wall, at a series of known capillary pressures (Michel, Mason, Curry & Tooke, 1974). Filtration coefficient varied from 0-69 X 10(-3) to 4-45 X 10(-3) mum. sec-1 .cm H2O-1 with an average value of 1-87 X 10(-3) mum. sec-1. cm H2O-1. 3. When the superfusate was made hypertonic by the addition of a test solute, the osmotic reflextion coefficient (sigma) of the capillary wall to test solute was calculated from the additional rate of filtration, the concentration of test solute in the superfusate and the filtration coefficient. Average values for sigma were: sodium chloride, 0-068 +/- 0-03 (three capillaries); urea, 0-071 +/- 0.015 (four capillaries); sucrose, 0-115 +/- 0-023 (seven capillaries); cyanocobalamin, 0-100 +/- 0-03 (three capillaries). 4. In further experiments, the osmotic reflextion coefficients to sodium chloride, urea and sucrose were determined in the same capillary. Five technically acceptable experiments were carried out. Although there were differences in the value of sigma between different capillaries, in any one capillary values of sigma were of the same magnitude and there appeared to be no significant trend with the molecular size of the test solute. 5. Our findings are inconsistent with the hypothesis that there is a single pathway for water and small hydrophilic molecules across the capillary wall. 6. Our results may be interpreted in terms of an exclusive channel for water in parallel with a channel shared by both water and small hydrophilic molecules. It is suggested that the exclusive water channel may be the membranes and cytoplasm of the endothelial cells and the shared channel may be located in the intercellular junctions. 7. Our data suggest the exclusive water channel represents about 10% of the total filtration coefficient in frog mesenteric capillaries. The shared channel shows relatively little restriction to the molecules investigated. Estimates of the volume flow throught the two channels are made for conditions where hydrostatic pressure differences and osmotic pressure differences are the driving forces.

Animals↗