Division of Gastroenterology, Hepatology and Nutrition, University of Miami Miller School of Medicine, Mailman Center for Child Development, Miami, Florida.
FRCSI Surgery, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Inflamm Bowel Dis. 2019 Jan 10;25(2):226-234. doi: 10.1093/ibd/izy201.
Initially thought to be a structure that only provided support to the abdominal contents, the mesentery has now gained special attention in the scientific community. The new approach of studying the mesentery as an individual organ has highlighted its importance in the development of local and systemic inflammatory diseases and its potential role in Crohn's disease. Its topographical relationship with the intestine in the setting of active inflammation and "creeping fat" is possibly one of the most important arguments for including the mesentery as an important factor in the pathogenesis of Crohn's disease. In this review, we discuss the importance of the mesentery from the anatomical and embryological standpoints. We also will summarize data on mesenteric inflammation in patients with Crohn's disease. The significance of the mesentery in systemic inflammatory syndromes will be discussed, and we provide an overview of primary inflammatory disorders of the mesentery. Finally, we discuss surgical approaches for patients requiring resection for Crohn's disease that incorporate mesenteric factors, pointing out recent data suggesting that these have the potential for improving outcomes and reducing disease recurrence. 10.1093/ibd/izy201_video1izy201.video15794169491001.
最初被认为只是为腹部内容物提供支撑的结构,肠系膜现在在科学界引起了特别关注。将肠系膜作为一个独立器官进行研究的新方法强调了它在局部和全身炎症性疾病发展中的重要性及其在克罗恩病中的潜在作用。在活动性炎症和“爬行脂肪”的背景下,肠系膜与肠道的拓扑关系可能是将肠系膜作为克罗恩病发病机制的重要因素之一的最重要论据之一。在这篇综述中,我们从解剖学和胚胎学的角度讨论了肠系膜的重要性。我们还将总结克罗恩病患者肠系膜炎症的数据。肠系膜在全身炎症综合征中的意义将被讨论,我们提供肠系膜原发性炎症性疾病的概述。最后,我们讨论了需要进行肠系膜因素切除术的克罗恩病患者的手术方法,指出最近的数据表明这些方法有可能改善结果并降低疾病复发率。10.1093/ibd/izy201_video1izy201.video15794169491001.