Jeong Yeon Jun, Cho Baik Hwan, Kinugasa Yusuke, Song Chang Ho, Hirai Ichiro, Kimura Wataru, Fujimiya Mineko, Murakami Gen
Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea.
Clin Anat. 2009 Sep;22(6):716-29. doi: 10.1002/ca.20846.
The developing mesocolon transversum was investigated using hematoxylin and eosin-stained semiserial sections derived from 17 human fetuses between 12 and 30 weeks of gestation. The mesocolon was attached to the mesoduodenum and greater omentum until 12 weeks. However, the fetal duodenal attachment appeared not to correspond to the right colic flexure in adults. The greater omentum and mesocolon were likely to be irregularly folded at the attachment site possibly because the developing transverse colon "ran into" and pushed up the greater omentum and pancreatic head. Lymphatic vessels invaded the indistinct fusion plane to destroy the primary configuration. Moreover, the mesocolon seemed to "seize" or take-over some parts of the splenic side of the greater omentum, but the thick gastric side containing the right gastroepiploic artery and vein remained along the greater curvature. Until 20 weeks, the left colic flexure was fixed to the pancreatic tail, and near the flexure the mesocolon also fused with the renal fascia. The left splenic end of the greater omentum was folded and fused together to form a thick ligament-like structure, i.e., the gastrocolic ligament. In addition, near the duodenojejunal junction, a peritoneal bridge was often seen containing the inferior mesenteric artery or vein. Although surgeons generally believe that the mesocolon can be gently detached from the greater omentum, the fusion plane in adults appears to be the result of secondary modification and simplification by vascular development.
利用苏木精-伊红染色的半连续切片，对17例妊娠12至30周的人类胎儿的发育中的横结肠系膜进行了研究。在妊娠12周之前，结肠系膜附着于十二指肠系膜和大网膜。然而，胎儿十二指肠的附着点似乎与成人的右结肠曲并不对应。大网膜和结肠系膜在附着部位可能不规则折叠，这可能是因为发育中的横结肠“撞上”并向上推挤大网膜和胰头。淋巴管侵入不明显的融合平面，破坏了原始结构。此外，结肠系膜似乎“占据”或接管了大网膜脾侧的一些部分，但包含胃网膜右动静脉的较厚胃侧仍沿胃大弯走行。直到20周时，左结肠曲固定于胰尾，在曲附近结肠系膜也与肾筋膜融合。大网膜的左脾端折叠并融合在一起，形成一个厚的韧带样结构，即胃结肠韧带。此外，在十二指肠空肠交界处附近，常可见到一个包含肠系膜下动静脉的腹膜桥。尽管外科医生通常认为结肠系膜可以从大网膜上轻柔分离，但成人的融合平面似乎是血管发育导致的二次修饰和简化的结果。
