[CYSTS OF THE MESOCOLON. REFLECTIONS APROPOS OF A GIANT CYSTIC LYMPHANGIOMA OF THE DESCENDING MESOCOLON].
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Cysts↗
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[Mesocolonic liposclerosis: isolated lesion of the mesocolon?].
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Humans↗
CT of the mesocolon. Part 1. Anatomic considerations.
To define the anatomy of the mesocolic attachment of the colon as seen on computed tomographic (CT) scans, the authors reviewed CT scans of patients with diseases of the colon and the pancreas and found that disease processes in these areas usually spread along the mesocolon. The plane of the mesocolon can be distinguished from the mesentery of the small bowel by identifying the vessels in the mesocolon that serve as its landmarks. These vessels include the ileocolic vessels and right colic vessels for the ascending mesocolon, the middle colic vessels for the transverse mesocolon, and the inferior mesenteric vein for the sigmoid and descending mesocolon. These vessels can be seen routinely on CT scans of the abdomen and pelvis, and knowledge of the anatomy of the mesocolon can help the radiologist understand and identify the pathways for spread of diseases of the colon and pancreas. Recognition of the anatomy of the mesocolon is also helpful in the identification of the pattern of recurrent disease after treatment.
Cecum↗
CT of the mesocolon. Part 2. Pathologic considerations.
The anatomy of the mesocolon can be seen on computed tomographic (CT) scans, and its CT anatomy can be described by using the vessels in the mesocolon as anatomic landmarks. Knowledge of this anatomy is the basis to understanding pathologic processes involving the mesocolon. Common pathologic conditions usually occur due to spread of disease between organs to which the mesocolon is attached, primarily the colon and pancreas. The disease may be a malignant lesion, a benign inflammatory process, or, rarely, a primary tumor of the mesocolon; the mode of spread may be via the lymphatic vessels, direct extension, vascular invasion, or vascular involvement. The authors demonstrate various pathologic conditions and modes of spread, as seen on CT scans, with emphasis on disease of the colon and pancreas. The pathway for the spread of disease and its progression in these organs can be predicted in patients with a known disease. More important, identification of abnormalities in the mesocolon leads to careful evaluation of the organs to which the mesocolon is attached.
Colonic Diseases↗
Primary intestinal obstruction complicated by persistent descending mesocolon.
Persistent descending mesocolon is an uncommon developmental anomaly which results from failure of fusion of the descending mesocolon with the posterior parietal peritoneum. It is asymptomatic in most cases and rarely causes intestinal obstruction. We report here a case of primary intestinal obstruction complicated by a persistent descending mesocolon. A 66-year-old man without prior laparotomy was admitted with a diagnosis of small bowel obstruction. Pre-operative investigation demonstrated a segmental jejunal stenosis and a persistent descending mesocolon as possible causes of the obstruction. Laparotomy showed that the cause of the obstruction was the jejunal stenosis, not the persistent descending mesocolon. The stenosis was resected, but correction of the anomaly was not performed. The patient made an uneventful recovery after the operation. From our limited experience, persistent descending mesocolon need not be surgically corrected when it is not considered to be the cause of obstruction and another definite cause co-exists.
Aged↗
[Giant fibroma of mesocolon transverse imitating tumor of ovary: a case report].
OBJECTIVES: The fibroma of mesocolon transverse is a rare lesion occurring primarily in age about 45-55 of years. The rarity of these lesions and the absence of characteristic clinical findings makes diagnosis difficult. STUDY DESIGN: The authors describe a case of fibroma mesocolon transverse in woman aged 75 years which became directed to Department of Gynecology & Obstetric in Hospital of Słupsk on account suspicions of ovarian tumor. RESULTS: Fibroma mesocolon transverse usually present as abdominal distention of long duration, pain, vomiting, less frequently as a palpable abdominal mass. Rarely they cause an acute abdominal surgical crisis clinically resembling appendicitis with peritonitis. Ultrasonography was the diagnostic method of choice. Other diagnostic modalities included intravenous pyelogram, barium enema examination, upper gastrointestinal tract series, CT scan and MRI in selected patients exclude gastrointestinal and genitourinary cysts and tumors. Histologically, several specific types could be distinguished of intra-abdominal lesions: lymphangioma, nonpancreatic pseudocyst, enteric duplication tumor, mesothelial tumor, enteric tumor, torsion of an omental segmental infarction cyst, hydatic omental cyst, omental fibromatosis tumor, ectopic ovarian cyst of the omentum, benign teratoma of the omentum or mesocolon. Treatment of choice of fibroma mesocolon transverse is always surgical (enucleation or resection of fibroma). Morbidity and mortality should be very low because of modern surgical techniques and follow-up procedures.
Aged↗
[RETRACTILE MESOCOLONITIS: PATHOPHISIOLOGY AND COMPLICATIONS]
The mesentery and mesocolon are structures with suspensory functions of the small bowel and colon respectively. When they are involved by prominent fibroblastic proliferation tissue, this is know as retractile mesenteritis and retractile mesocolonitis. The retractile mesocolonitis is associated with sigmoid volvulus, and is a common finding in the rural areas of Puno (Peru). The common macroscopic appearance consists of a markedly thickened mesentery of rubbery consistency, and the retraction predisposing a twist of the bowel. The histologic features include fibrosis with massive accumulation of dense collagenous tissue. These lesions can be the expression of a reparative proccess that occurs in response to mesenteric injury of enteric bacteria (bacterial transiocation) or inflammatory response. Repeated attacks of bacterial colitis might lead to scarring of the mesocolon.
Journal Article↗
Successful radical surgery for an undifferentiated gallbladder carcinoma with lymph node metastases to the mesocolon.
We report successful radical systematic surgery for an undifferentiated gallbladder carcinoma with metastasis to the mesocolonic lymph nodes. The patient, a 70-year-old woman, was admitted with abdominal fullness and appetite loss. Imaging modalities revealed a 10-cm tumor originating from the gallbladder and infiltrating both the liver and transverse colon. As multiple mesocolonic lymph node metastasis was confirmed on laparotomy, right hemicolectomy with systematic lymph node dissection (D3 resection) was performed, in addition to extended cholecystectomy with partial resection of segments 4, 5 and 6 of the liver and distal gastrectomy. Histologically, the tumor was diagnosed as an undifferentiated carcinoma, and metastases were indentified in the mesocolonic lymph nodes (17/50 nodes) but not in the peri-gallbladder lymph nodes (0/16 nodes). The patient has been recurrence-free for 4 years after the operation. This case illustrates that even if gallbladder cancer infiltrates into adjacent organs with regional lymph node metastasis, it is of value to perform radical surgery with systematic lymph node dissection for the involved organs.
Aged↗
[Encapsulated hematoma of the sigmoid mesocolon. Apropos of an unusual case in Niger].
After reporting the case of a patient with an asymptomatic encapsulated hematoma of the sigmoid mesocolon, the main causes of hematomas of the GI tract will be reviewed. Hematomas of the mesocolon are rare. The morphology of an hematoma is related to its location and its US appearance can vary considerably over time. To our knowledge only nine cases of hematoma of the sigmoid mesocolon have been reported. The unusual nature of this case lies in the encapsulated nature of the hematoma, its unusual morphology and the lack of apparent underlying etiology, all elements that lead us to the conclusion that this hematoma was idiopathic and spontaneous.
Gastrointestinal Hemorrhage↗
Solid and papillary neoplasm arising from an ectopic pancreas in the mesocolon.
A case of solid and papillary neoplasm of a mesocolonic ectopic pancreas in a 13-yr-old girl is presented. An 8-cm, well-encapsulated, and partly calcified tumor which protruded from the mesocolon was resected surgically. Histologically, the tumor showed either solid sheets or papillary arrangements (around the vascular core) of uniformly small cells with alpha 1-antitrypsin-positive cytoplasm. Some of the tumor cells had zymogenlike granules, suggesting acinar cell differentiation. At the base of this tumor, small pancreatic tissues (islet, acinar, and ductular cells) were detected in the mesocolonic tissue. Incidences of both ectopic pancreas outside the gastrointestinal wall and solid and papillary neoplasm of the pancreas are rare, and this is the first case reported in the literature.
Adolescent↗
A case report of epithelioid leiomyosarcoma of transverse mesocolon: diagnosis and treatment.
A case of epithelioid leiomyosarcoma of the transverse mesocolon in a 45-year-old man was reported. The patient had a rapidly growing mass in the left upper quadrant. Ultrasonography, gastrointestinography, and abdominal computed tomography showed that the mass was separated from the pancreas, the gastrointestinal tract, and the retroperitoneal organs. Preoperatively the primary origin of this tumor was related to the transverse mesocolon. On laparotomy the tumor of 5cm by 6cm by 3cm in size was found in the anterior left of the transverse mesocolon and the mass was resected entirely. The patient is well 18 months after surgical treatment with no evidence of recurrence.
Humans↗
Laparoscopic diagnosis of ischemic necrosis of the descending colon after rectal prolapse and rupture of the mesocolon in two postpartum mares.
Two mares were referred for evaluation after dystocia and rectal prolapse. Diagnostic laparoscopy, performed while the horses were standing, was used to evaluate the condition of the distal portion of the colon, rectum, uterus, and mesocolon. In both horses, laparoscopic observation revealed tears in the mesocolon of the descending colon. Exploration from the left or right flank was adequate. Because of the poor prognosis associated with the findings, euthanasia was elected at completion of laparoscopy. Tears in the mesocolon are not easily detected by use of traditional tests. Laparoscopy proved to be a more thorough means of evaluating the caudal portion of the abdomen including the digestive and urogenital tracts in these horses. As a less invasive diagnostic tool, laparoscopy can be performed earlier in the course of disease than alternative approaches for direct viewing. Furthermore, laparoscopy can be used to access the viability of tissues as well as the location and severity of lesions for prognostic purposes. The distal portion of the descending colon can also be evaluated to determine whether celiotomy with anastomosis or colostomy may be the surgical procedure of choice.
Animals↗
Well differentiated "lipoma-like" liposarcoma of the sigmoid mesocolon and multiple lipomatosis of the rectosigmoid colon. Report of a case.
Liposarcoma is the second most common soft tissue sarcoma in adults. These neoplasms take their origin from primitive mesenchymal cells and are rarely encountered in fat rich areas, such as subcutaneous tissue and/or the subserosa of the intestinal tract which, on the contrary, are the two most common sites of lipomas. The two major locations of liposarcomas are the extremities and the retroperitoneum followed with much less frequency by the inguinal region. Other sites are uncommon, particularly the mesentery (9 cases to date in the literature) and, even more so, the mesocolon (only 3 cases of primary sarcoma of the mesocolon reported to date). This paper reports on the case of a well differentiated "lipoma-like" liposarcoma of the sigmoid mesocolon, associated with multiple lipomatosis of the recto-sigmoid colon in a 75 year-old female patient. Surgical treatment consisted of a trans-anal extra-peritoneal anterior resection by CEEA 28 stapler under endoscopic vision. The patient has been followed up for the last 2 years and is still disease-free and well. The peculiarity of the case consists in the contemporaneous presence in close contiguity of two different rare neoplasms whose association is not yet known.
Adult↗
A giant tumor of the mesocolon found to be metastasis from an alpha-fetoprotein-producing gastric carcinoma: report of a case.
We present herein an extremely rare case of metastasis from a gastric carcinoma to the mesocolon. A 71-year-old woman underwent a laparotomy for gastric cancer with an intra-abdominal mass. Her serum alpha-fetoprotein level was very high at 3,560 ng/ml. The abdominal mass was subsequently revealed to be a metastatic tumor of the transverse mesocolon derived from an alpha-fetoprotein-producing gastric carcinoma, but no other metastatic focus was found. An immunohistochemical study revealed alpha-fetoprotein-positive cells in both lesions. The serum alpha-fetoprotein level became normal after the operation which was followed by a course of chemotherapy, and no recurrence has been observed thus far in 6 months of follow up.
Adenocarcinoma↗
A mucinous tumor of the mesocolon with features of borderline malignancy.
Primary mucinous cystadenoma of the mesocolon is a rare tumor with an uncertain histogenesis. A 38-year-old woman was diagnosed with a 17-cm cystic lesion in the left abdomen, identified as a mucinous cystadenoma of the mesocolon. This type of tumor appears rarely in extraovarian sites. We believe that metaplasia, either celomic or mucinous, is the most likely pathogenic mechanism. On rare occasions, a borderline or invasive component may be present.
Adult↗
Pictorial review: Subperitoneal spaces of the broad ligament and sigmoid mesocolon--imaging findings.
In this report, we illustrate the imaging findings of diseases in the subperitoneal space of the broad ligament and sigmoid mesocolon and discuss the pathways of subperitoneal spread of disease. The subperitoneal space of the broad ligament and sigmoid mesocolon is continuous with that of the parietal peritoneum overlying the pelvic wall. Extraperitoneal diseases originating in the pelvis can extend, via the abdominopelvic vasculature or fascial-defined compartment, superiorly into the retroperitoneal compartments of the abdomen.
Broad Ligament↗
[Accessory pancreatic cyst located in the mesocolon in a child (author's transl)].
Case reports of a 1.5-year-old child who had a cyst in the mesocolon ascendens arising from ectopic pancreatic tissue. It is the third case of an accessory pancreatic cyst and at the same time, the first case in which the cyst in the mesocolon ascends has been found in early childhood. Pathogenesis, diagnosis and symptomatology are discussed.
Choristoma↗
Solid and papillary epithelial neoplasm arising in heterotopic pancreatic tissue of the mesocolon.
AIM: Solid and papillary epithelial neoplasm (SPEN) is an uncommon pancreatic tumour. Very rarely it has also been described outside the pancreas, usually arising from heterotopic pancreatic tissue. This report summarises all the published extrapancreatic SPENs and documents the sixth such case arising from heterotopic pancreatic tissue of the transverse mesocolon in a 15 year old girl. METHODS/RESULTS: Histological and immunohistochemical examination revealed typical papillary and solid areas composed of columnar, cuboidal, and round cells, which were focally positive for vimentin, cytokeratin, neurone specific enolase, carcinoembryonic antigen, alpha1-antitrypsin, alpha1-antichymotrypsin, and negative for neuroendocrine markers (neurofilament, PGP 9.5, chromogranin A, synaptophysin, and S100), p53, and oestrogen and progesterone receptors. Electron microscopy showed scant zymogen but no neurosecretory granules. In agreement with the flow cytometric result s of diploidy, comparative genomic hybridisation (CGH) did not reveal loss or gain of genetic material, and the in situ hybridisation analysis of the RB1 and p53 genes revealed no abnormality in the 13q and 17p arms. CONCLUSIONS: Immunohistochemical and electron microscopic data support exocrine differentiation. The CGH and the flow cytometric results suggest a subtle, yet unknown genetic change, rather than a large genetic alteration. RB1 and p53 in situ hybridisation ruled out the role of deletion at these sites in the pathogenesis of SPEN. Interestingly, review of the published and the present heterotopic pancreatic SPENs identified the mesocolon as the most common anatomical site (four of six), despite the very rare occurrence of ectopic pancreatic tissue at this site.
Adolescent↗