Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Giulia Turri; Michele Carvello; Nadav Ben David; Antonino Spinelli

doi:10.1055/s-0042-1743590

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2022; 35(04): 321-327
DOI: 10.1055/s-0042-1743590

Review Article

Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Giulia Turri

¹Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy

²Department of Surgical Sciences, Dentistry, Gynecology, and Pediatrics, Division of General and Hepatobiliary Surgery, University of Verona, Verona, Italy

,

Michele Carvello

¹Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy

,

Nadav Ben David

¹Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy

,

Antonino Spinelli

¹Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy

³Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

› Author Affiliations

Abstract

Crohn's disease (CD) is a chronic relapsing inflammatory bowel disease with unknown etiology. Up to 80% of patients will eventually require surgery throughout their lifetime, and often repeated resections are required for disease recurrence. Observations of “creeping fat” surrounding the diseased intestine renewed interest in the mesentery, recently defined as an organ with endocrine and immune functions. According to the inside-out model, the mesentery may be primarily affected in CD and subsequent cause alterations in the mucosa. Recently, lower surgical recurrence rates have been reported with en-bloc excision of the mesentery adjoining the diseased intestine. Results of ongoing randomized controlled trials may clarify the role of the mesentery in CD and possibly lead to its adoption as standard during surgery for Crohn's disease.

Keywords

mesentery - Crohn's disease - inflammatory bowel disease - surgery

Full Text

References

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