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Misunderstood mesentery gets an upgrade

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With great enthusiasm and repercussion in the international media, a group of scientists announced that the mesentery, a structure located in the gastric cavity, was actually a new organ rather than a series of separate parts and, therefore, should be studied as such.

A request by Dr. J. Calvin Coffey, a researcher at Limerick University Hospital in Ireland, to reclassify this structure as an organ was published in the prestigious British journal Lancet of Gastroenterology and Hepatology, and incorporated into “Gray’s Anatomy,” one of the most consulted medical texts worldwide.

Around 1510, the genius that was Leonardo da Vinci had already described the mesentery, but without all the details of the current investigators. Sir Frederick Treves, who was the surgeon of Queen Victoria and King Edward VII, and who performed the first appendectomy in London in 1888, was the first to give a detailed anatomical description of this organ. However, despite the years that have passed since then, the mesentery is one of the most ignored organs of the human body.

The mesentery is a double fold of the peritoneum that joins the intestines to the wall of the abdomen and holds them there. The structure of the mesentery was long thought fragmented. However, in 2012, after detailed and exhaustive traditional microscopic investigations, along with using electron microscopy and even 3-D images, it was found to be a unique and continuous structure.

Its importance is not small, however. The mesentery occupies a central place in the digestive system. What is known so far is that it acts as a kind of “shock absorber” of the intestines, which protects them from the effects of gravity. In certain circumstances you may have mesenteric venous thrombosis, which is a blood clot in one or more of the major veins that drains blood from the intestine. There are two of these veins through which the blood leaves the intestine. This condition interrupts the blood supply to the intestine and can cause considerable intestinal damage.

“Better understanding and further study of the mesentery could lead to less invasive surgery, fewer complications, faster patient recovery, and reduced medical costs,” Coffey said. He added: “We have established anatomy and structure. The next step is to define its function. If we understand the function, we can identify the abnormality and there we will find the disease.”

Further knowledge of the structure of the mesentery could lead to new approaches to treat diseases such as intestinal cancer and inflammatory and vascular diseases of the intestine. At the same time, it is worth studying the role of the mesentery in blood, immunological, endocrine and metabolic diseases.

The reasons for some pathologies such as abnormal bowel position (malrotation), torsion of the mesentery (volvulus), which requires emergency surgery, or Crohn’s Disease, which is a chronic inflammatory condition of the intestinal tract, may also be better understood.

The great value of this finding, which through the use of different techniques confirms the mesentery as a new organ of the human body, is that it focuses attention on it and on the need to study it more thoroughly to improve the health of all.

As Dr. Carlos Brodersen, head of gastroenterology at Durand Hospital in Buenos Aires, stated: “The mesentery has always been well-known by surgeons and doctors. Now it is time to recognize the services it renders.”

Dr. Cesar Chelala has conducted biomedical research at the Campomar Foundation in Buenos Aires, the New York City Public Health Institute, and the New York University School of Medicine.