Now that we have reviewed the key concepts about the anatomy and radiologic anatomy of the mesentery,
we can approach the mesentery pathologies by dividing them into primary and secondary.
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753339?maxheight=300&maxwidth=300)
Table 1: Table of contents
Primary
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753340?maxheight=300&maxwidth=300)
Fig. 11: Left internal paraduodenal hernia
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753341?maxheight=300&maxwidth=300)
Fig. 12: Same case as Fig. 11: Left internal paraduodenal hernia
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755096?maxheight=300&maxwidth=300)
Fig. 13: Internal Herniation
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753342?maxheight=300&maxwidth=300)
Fig. 14: Malrotation: Case 1.
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753343?maxheight=300&maxwidth=300)
Fig. 15: Malrotation Case 2.
References: Fleury Medicina Diagnóstica, São Paulo, Brazil
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755182?maxheight=300&maxwidth=300)
Fig. 16: Malrotation
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753344?maxheight=300&maxwidth=300)
Fig. 17: Sigmoid Volvulus
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753345?maxheight=300&maxwidth=300)
Fig. 18: Same case as Fig. 17: Sigmoid Volvulus Video - specific CT sign for volvulus is the whirl sign: vessels twisted like a whirlwind in the center of the bowel twist.
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755183?maxheight=300&maxwidth=300)
Fig. 19: Volvulus
- Vascular - Mesenteric bleeding/hematoma
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753346?maxheight=300&maxwidth=300)
Fig. 20: Vascular - Mesenteric bleeding/hematoma
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755184?maxheight=300&maxwidth=300)
Fig. 21: Vascular - Mesenteric bleeding/hematoma
- Vascular - Mesenteric ischemia
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753347?maxheight=300&maxwidth=300)
Fig. 22: Vascular - Mesenteric ischemia
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755185?maxheight=300&maxwidth=300)
Fig. 23: Vascular - Mesenteric ischemia
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753348?maxheight=300&maxwidth=300)
Fig. 24: Mesenteric cyst
References: Fleury Medicina Diagnóstica, São Paulo, Brazil
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755186?maxheight=300&maxwidth=300)
Fig. 25: Mesenteric cyst
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753349?maxheight=300&maxwidth=300)
Fig. 26: Hemangiomatosis
References: Diagnósticos da América S.A. DASA. São Paulo, SP, Brazil
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755187?maxheight=300&maxwidth=300)
Fig. 27: Hemangiomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753350?maxheight=300&maxwidth=300)
Fig. 28: Crohn’s Disease
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755188?maxheight=300&maxwidth=300)
Fig. 29: Crohn’s Disease
Primary Neoplasms
Tumors with primary manifestation in the peritoneum in the absence of a visceral site of origin.
They arise from mesothelial cells,
submesothelial mesenchymal cells,
and uncommitted stem cells .
Because the origins of some primary peritoneal tumors are obscure,
these lesions are difficult to classify precisely.
Mesothelial tumors: peritoneal malignant mesothelioma ,
well-differentiated papillary mesothelioma, multicystic mesothelioma and adenomatoid tumor.
Epithelial tumors: primary peritoneal serous carcinoma and primary peritoneal serous borderline tumor.
Smooth muscle tumor: leiomyomatosis peritonealis disseminata.
Tumors of uncertain origin: desmoplastic small round cell tumor and solitary fibrous tumor.
- Peritoneal Malignant Mesothelioma
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753351?maxheight=300&maxwidth=300)
Fig. 30: Mesothelioma
References: Fleury Medicina Diagnóstica, São Paulo, Brazil
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753352?maxheight=300&maxwidth=300)
Fig. 31: Same case as Fig. 30: Mesothelioma
References: Fleury Medicina Diagnóstica, São Paulo, Brazil
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755189?maxheight=300&maxwidth=300)
Fig. 32: Peritoneal Malignant Mesothelioma
- Desmoplastic Small Round Cell Tumor
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753353?maxheight=300&maxwidth=300)
Fig. 33: Desmoplastic Small Round Cell Tumor
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753354?maxheight=300&maxwidth=300)
Fig. 34: Same case as Fig. 33: Desmoplastic Small Round Cell Tumor
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755190?maxheight=300&maxwidth=300)
Fig. 35: Desmoplastic Small Round Cell Tumor
Primary- Inflammatory
- Sclerosing mesenteritis - mesenteric panniculitis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753355?maxheight=300&maxwidth=300)
Fig. 36: Sclerosing mesenteritis – mesenteric panniculitis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755191?maxheight=300&maxwidth=300)
Fig. 37: Sclerosing mesenteritis – mesenteric panniculitis
- Sclerosing mesenteritis – retractile mesenteritis IgG4 related
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753356?maxheight=300&maxwidth=300)
Fig. 38: Sclerosing mesenteritis – Retractile mesenteritis IgG4 related
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755192?maxheight=300&maxwidth=300)
Fig. 39: Sclerosing mesenteritis – retractile mesenteritis IgG4 related
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753357?maxheight=300&maxwidth=300)
Fig. 40: Abdominal cocoon
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755193?maxheight=300&maxwidth=300)
Fig. 41: Abdominal cocoon
Secondary Neoplasms
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/753358?maxheight=300&maxwidth=300)
Fig. 42: Pseudomyxoma
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755195?maxheight=300&maxwidth=300)
Fig. 43: Pseudomyxoma
- Lymphomatosis x Carcinomatosis x Sarcomatosis
Conditions with overlapping characteristics:
Carcinomatosis: Peritoneal and omental seeding are known sites of dissemination of metastatic carcinoma,
most commonly arising from the ovary,
colon and stomach.
Lymphadenopathy is usually located around the primary tumor.
Ascites is usually marked.
Lymphomatosis: omental caking with homogeneous bulky masses,
in addition to a diffuse distribution of enlarged lymph nodes.
Sarcomatosis: may present bulky masses,
but they are frequently heterogeneous,
hypervascular and may be associated with hemoperitoneum.
Lymphnode enlargement is rare.
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754446?maxheight=300&maxwidth=300)
Fig. 44: Lymphomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755197?maxheight=300&maxwidth=300)
Fig. 45: Lymphomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754447?maxheight=300&maxwidth=300)
Fig. 46: Carcinomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755198?maxheight=300&maxwidth=300)
Fig. 47: Carcinomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754448?maxheight=300&maxwidth=300)
Fig. 48: Sarcomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755199?maxheight=300&maxwidth=300)
Fig. 49: Sarcomatosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754450?maxheight=300&maxwidth=300)
Fig. 50: Peritoneal GIST
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755200?maxheight=300&maxwidth=300)
Fig. 51: Peritoneal GIST
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754451?maxheight=300&maxwidth=300)
Fig. 52: Omental cake
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755201?maxheight=300&maxwidth=300)
Fig. 53: Omental cake
Secondary - Infectious
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754452?maxheight=300&maxwidth=300)
Fig. 54: Tuberculosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755202?maxheight=300&maxwidth=300)
Fig. 55: Tuberculosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754453?maxheight=300&maxwidth=300)
Fig. 56: Atypical Mycobacteriosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755468?maxheight=300&maxwidth=300)
Fig. 57: Atypical Mycobacteriosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754454?maxheight=300&maxwidth=300)
Fig. 58: Actinomycosis Infection
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755484?maxheight=300&maxwidth=300)
Fig. 59: Actinomycosis Infection
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754455?maxheight=300&maxwidth=300)
Fig. 60: Hydatidosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755491?maxheight=300&maxwidth=300)
Fig. 61: Hydatidosis
Secondary - Miscellany
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/754456?maxheight=300&maxwidth=300)
Fig. 62: Splenosis
![](https://epos.myesr.org/posterimage/esr/ecr2018/143415/media/755508?maxheight=300&maxwidth=300)
Fig. 63: Splenosis