human anatomy Human anatomy (gr. ἀνατομία, "dissection", from ἀνά, "up", and τέμνειν, "cut") is primarily the scientific study of the morphology of the human body. Anatomy is subdivided into gross anatomy and microscopic anatomy. Gross ...

, the mesentery is an

organ Organ and organs may refer to: Biology * Organ (biology), a group of tissues organized to serve a common function * Organ system, a collection of organs that function together to carry out specific functions within the body. Musical instruments ...

that attaches the

intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. T ...

s to the

posterior abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the vi ...

, consisting of a double fold of the

peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesotheli ...

. It helps (among other functions) in storing

fat In nutrition science, nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such chemical compound, compounds, most commonly those that occur in living beings or in food. The term often refers specif ...

and allowing

blood vessel Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...

lymphatics The lymphatic vessels (or lymph vessels or lymphatics) are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessel ...

, and

nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...

s to supply the intestines. The (the part of the mesentery that attaches the colon to the abdominal wall) was formerly thought to be a fragmented structure, with all named parts—the ascending, transverse, descending, and sigmoid mesocolons, the mesoappendix, and the mesorectum—separately terminating their insertion into the posterior abdominal wall. However, in 2012, new

microscopic The microscopic scale () is the scale of objects and events smaller than those that can easily be seen by the naked eye, requiring a lens or microscope to see them clearly. In physics, the microscopic scale is sometimes regarded as the scale betwe ...

and electron microscopic

examinations An examination (exam or evaluation) or test is an educational assessment intended to measure a test-taker's knowledge, skill, aptitude, physical fitness, or classification in many other topics (e.g., beliefs). A test may be administered verba ...

showed the mesocolon to be a single structure derived from the

duodenojejunal flexure The duodenojejunal flexure or duodenojejunal junction, also known as the angle of Treitz, is the border between the duodenum and the jejunum. Structure The ascending portion of the duodenum ascends on the left side of the aorta, as far as the lev ...

and extending to the distal mesorectal layer. Thus the mesentery is an

internal organ In a multicellular organism, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to a ...

Structure

The mesentery of the

small intestine The small intestine or small bowel is an organ (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...

arises from the root of the mesentery (or mesenteric root) and is the part connected with the structures in front of the

vertebral column The spinal column, also known as the vertebral column, spine or backbone, is the core part of the axial skeleton in vertebrates. The vertebral column is the defining and eponymous characteristic of the vertebrate. The spinal column is a segmente ...

. The root is narrow, about 15 cm long, 20 cm in width, and is directed obliquely from the

at the left side of the second

lumbar vertebra The lumbar vertebrae are located between the thoracic vertebrae and pelvis. They form the lower part of the back in humans, and the tail end of the back in quadrupeds. In humans, there are five lumbar vertebrae. The term is used to describe the ...

to the right

sacroiliac joint The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The ...

. The root of the mesentery extends from the duodenojejunal flexure to the ileocaecal junction. This section of the small intestine is located centrally in the abdominal cavity and lies behind the transverse colon and the

greater omentum Greater may refer to: *Greatness, the state of being great *Greater than, in inequality * ''Greater'' (film), a 2016 American film *Greater (flamingo), the oldest flamingo on record * "Greater" (song), by MercyMe, 2014 * Greater Bank, an Australi ...

. The mesentery becomes attached to the colon at the gastrointestinal margin and continues as the several regions of the mesocolon. The parts of the mesocolon take their names from the part of the colon to which they attach. These are the transverse mesocolon attaching to the transverse colon, the sigmoid mesocolon attaching to the sigmoid colon, the mesoappendix attaching to the appendix, and the mesorectum attaching to the upper third of the rectum. The mesocolon regions were traditionally taught to be separate sections with separate insertions into the posterior abdominal wall. In 2012, the first detailed observational and

histological Histology, also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...

studies of the mesocolon were undertaken and this revealed several new findings. The study included 109 patients undergoing open, elective, total abdominal

colectomy Colectomy (''wikt:colo-#Prefix, col-'' + ''wikt:-ectomy#Suffix, -ectomy'') is the surgical removal of any extent of the Large intestine#Structure, colon, the longest portion of the large bowel. Colectomy may be performed for prophylactic, curativ ...

. Anatomical observations were recorded during the surgery and on the post-operative specimens. These studies showed that the mesocolon is continuous from the ileocaecal to the rectosigmoid level. It was also shown that a mesenteric confluence occurs at the ileocaecal and rectosigmoid junctions, as well as at the hepatic and splenic flexures and that each confluence involves peritoneal and omental attachments. The proximal rectum was shown to originate at the confluence of the mesorectum and mesosigmoid. A plane occupied by perinephric fascia was shown to separate the entire apposed small intestinal mesentery and the mesocolon from the

retroperitoneum The retroperitoneal space (retroperitoneum) is the anatomical space (sometimes a potential space) behind (''retro'') the peritoneum. It has no specific delineating anatomical structures. Organs are retroperitoneal if they have peritoneum on their ...

. Deep in the

pelvis The pelvis (: pelves or pelvises) is the lower part of an Anatomy, anatomical Trunk (anatomy), trunk, between the human abdomen, abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also c ...

, this fascia coalesces to give rise to

presacral fascia The presacral fascia lines the anterior aspect of the sacrum, enclosing the sacral vessels and nerves. It continues anteriorly as the pelvic parietal fascia, covering the entire pelvic cavity. The presacral fascia is limited postero-inferiorly, ...

Flexural anatomy

Flexural anatomy is frequently described as a difficult area. It is simplified when each flexure is considered as being centered on a mesenteric contiguity. The ileocaecal flexure arises at the point where the ileum is continuous with the caecum around the ileocaecal mesenteric flexure. Similarly, the

hepatic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. S ...

is formed between the right mesocolon and transverse mesocolon at the mesenteric confluence. The colonic component of the hepatic flexure is draped around this mesenteric confluence. Furthermore, the

splenic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. St ...

is formed by the mesenteric confluence between the transverse and left mesocolon. The colonic component of the splenic flexure occurs lateral to the mesenteric confluence. At every flexure, a continuous peritoneal fold lies outside the colonic/mesocolic complex tethering this to the posterior abdominal wall.

Mesocolon regions

The transverse mesocolon is that section of the mesentery attached to the

transverse colon In human anatomy, the transverse colon is the longest and most movable part of the Large intestine#Structure, colon. Anatomical position It crosses the abdomen from the ascending colon at the right colic flexure (hepatic flexure) with a downward ...

that lies between the

colic flexures In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Stru ...

. The sigmoid mesocolon is that region of the mesentery to which the

sigmoid colon The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''s ...

is attached at the gastrointestinal mesenteric margin. The mesoappendix is the portion of the mesentery connecting the

ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may ...

to the

appendix Appendix (: appendices or appendixes) may refer to: __NOTOC__ In documents * Addendum, an addition made to a document by its author after its initial printing or publication * Bibliography, a systematic list of books and other works * Index (publis ...

. It may extend to the tip of the appendix. It encloses the

appendicular artery The appendicular artery, also known as the appendiceal artery, commonly arises from the terminal branch of the ileocolic artery, or less commonly from the posterior cecal artery or an ileal artery. It descends behind the termination of the ileum a ...

and vein, as well as

lymph Lymph () is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to be recirculated. At the ori ...

atic vessels, nerves, and often a

lymph node A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that includ ...

. The mesorectum is that part attached to the upper third of the rectum.

Peritoneal folds

Understanding the macroscopic structure of the mesenteric organ meant that associated structures—the peritoneal folds and congenital and omental adhesions—could be better appraised. The small intestinal mesenteric fold occurs where the small intestinal mesentery folds onto the posterior abdominal wall and continues laterally as the right mesocolon. During mobilization of the small intestinal mesentery from the posterior abdominal wall, this fold is incised, allowing access to the interface between the small intestinal mesentery and the retroperitoneum. The fold continues at the inferolateral boundary of the ileocaecal junction and turns as the right paracolic peritoneal fold. This fold is divided during lateral to medial mobilization, permitting the surgeon to serially lift the right colon and associated mesentery off the underlying fascia and retroperitoneum. At the hepatic flexure, the right lateral peritoneal fold turns and continues medially as the hepatocolic peritoneal fold. Division of the fold in this location permits separation of the colonic component of the hepatic flexure and mesocolon off the retroperitoneum. Interposed between the hepatic and splenic flexures, the greater omentum adheres to the transverse colon along a further band or fold of peritoneum. Dissection through this allows access to the cephalad (top) surface of the transverse mesocolon. Focal adhesions frequently tether the greater omentum to the cephalad aspect of the transverse mesocolon. The left colon is associated with a similar anatomic configuration of peritoneal folds; the splenic peritoneal fold is contiguous with the left lateral paracolic peritoneal fold at the splenic flexure. Division of the latter similarly allows for the separation of the left colon and associated mesentery off the underlying fascia and frees it from the retroperitoneum. The left lateral paracolic peritoneal fold continues distally at the lateral aspect of the mobile component of the mesosigmoid.

Microanatomy

Determination of the macroscopic structure of the mesenteric organ allowed a recent characterisation of the histological and electron microscopic properties. The microscopic structure of the mesocolon and associated fascia is consistent from ileocecal to mesorectal levels. A surface

mesothelium The mesothelium is a membrane composed of simple squamous epithelium, simple squamous epithelial cells of mesodermal origin, which forms the lining of several body cavities: the pleura (pleural cavity around the lungs), peritoneum (abdominopelvic ...

and underlying connective tissue is universally apparent.

Adipocytes Adipocytes, also known as lipocytes and fat cells, are the cells that primarily compose adipose tissue, specialized in storing energy as fat. Adipocytes are derived from mesenchymal stem cells which give rise to adipocytes through adipogenesis. ...

lobules within the body of the mesocolon are separated by fibrous

septa SEPTA, the Southeastern Pennsylvania Transportation Authority, is a regional public transportation authority that operates bus, rapid transit, commuter rail, light rail, and electric trolleybus services for nearly four million people througho ...

arising from submesothelial connective tissue. Where apposed to the retroperitoneum, two mesothelial layers separate the mesocolon and underlying retroperitoneum. Between these is

Toldt's fascia Toldt's fascia, is a discrete layer of connective tissue containing lymphatic channels. It is found between the two mesothelial layers that separate the mesocolon from the underlying retroperitoneum. It was first described by the Austrian anatomist ...

, a discrete layer of connective tissue. Lymphatic channels are evident in mesocolic connective tissue and in Toldt's fascia.

Development

Dorsal mesentery

The

primitive gut The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. T ...

is suspended from the posterior abdominal wall by the dorsal mesentery. The gastrointestinal tract and associated dorsal mesentery are subdivided into

foregut The foregut in humans is the anterior part of the alimentary canal, from the distal esophagus to the first half of the duodenum, at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. ...

midgut The midgut is the portion of the human embryo from which almost all of the small intestine and approximately half of the large intestine develop. After it bends around the superior mesenteric artery, it is called the "midgut loop". It comprises ...

, and

hindgut The hindgut (or epigaster) is the posterior ( caudal) part of the alimentary canal. In mammals, it includes the distal one third of the transverse colon and the splenic flexure, the descending colon, sigmoid colon and up to the ano-rectal junct ...

regions based on the respective blood supply. The foregut is supplied by the

celiac trunk The celiac () artery (also spelled coeliac in British English), also known as the celiac trunk or truncus coeliacus, is the first major branch of the abdominal aorta. It is about 1.25 cm in length. Branching from the aorta at thoracic vert ...

, the midgut is supplied by the

superior mesenteric artery In human anatomy, the superior mesenteric artery (SMA) is an artery which arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies blood to the intestine from the lower part of the ...

(SMA), and the hindgut is supplied by the

inferior mesenteric artery In human anatomy, the inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The region ...

(IMA). This division is established by the fourth week of

development Development or developing may refer to: Arts *Development (music), the process by which thematic material is reshaped * Photographic development *Filmmaking, development phase, including finance and budgeting * Development hell, when a proje ...

. After this, the midgut undergoes a period of rapid elongation, forcing it to herniate through the

navel The navel (clinically known as the umbilicus; : umbilici or umbilicuses; also known as the belly button or tummy button) is a protruding, flat, or hollowed area on the abdomen at the attachment site of the umbilical cord. Structure The u ...

. During herniation, the midgut rotates 90° anti-clockwise around the axis of the SMA and forms the midgut loop. The cranial portion of the loop moves to the right and the caudal portion of the loop moves toward the left. This

rotation Rotation or rotational/rotary motion is the circular movement of an object around a central line, known as an ''axis of rotation''. A plane figure can rotate in either a clockwise or counterclockwise sense around a perpendicular axis intersect ...

occurs at about the eighth week of development. The

cranial Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Thi ...

portion of the loop will develop into the jejunum and most of the ileum, while the

caudal Caudal may refer to: Anatomy * Caudal (anatomical term) (from Latin ''cauda''; tail), used to describe how close something is to the trailing end of an organism * Caudal artery, the portion of the dorsal aorta of a vertebrate that passes into th ...

part of the loop eventually forms the terminal portion of the ileum, the

ascending colon In the anatomy of humans and homologous primates, the ascending colon is the part of the colon located between the cecum and the transverse colon. Characteristics and structure The ascending colon is smaller in calibre than the cecum from wh ...

and the initial two-thirds of the transverse colon. As the foetus grows larger, the mid-gut loop is drawn back through the umbilicus and undergoes a further 180° rotation, completing a total of 270° rotation. At this point, about 10 weeks, the

caecum The cecum ( caecum, ; plural ceca or caeca, ) is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix, ...

lies close to the

liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...

. From here it moves in a cranial to caudal direction to eventually lie in the lower right portion of the abdominal cavity. This process brings the ascending colon to lie vertically in the lateral right portion of the abdominal cavity apposed to the posterior abdominal wall. The descending colon occupies a similar position on the left side.Mitchell B, Sharma R. Embryology: An Illustrated Colour Text, 2e. Churchill Livingstone; 2 edition (June 22, 2009). . During these topographic changes, the dorsal mesentery undergoes corresponding changes. Most anatomical and embryological textbooks say that after adopting a final position, the ascending and descending mesocolons disappear during embryogenesis. ''Embryology—An Illustrated Colour Text'', "most of the mid-gut retains the original dorsal mesentery, though parts of the duodenum derived from the mid-gut do not. The mesentery associated with the ascending colon and descending colon is resorbed, bringing these parts of the colon into close contact with the body wall." In ''The Developing Human'', the author states, "the mesentery of the ascending colon fuses with the parietal peritoneum on this wall and disappears; consequently the ascending colon also becomes retroperitoneal".Moore KL, TPersaud TVN, Torchia MG. The Developing Human: Clinically Oriented Embryology with Student Consult Online Assess, 9th Edition. Saunders; To reconcile these differences, several theories of embryologic mesenteric development—including the "regression" and "sliding" theories—have been proposed, but none has been widely accepted. The portion of the dorsal mesentery that attaches to the

greater curvature The curvatures of the stomach are the long, convex, lateral surface, and the shorter, concave, medial surface of the stomach, which are referred to as the greater and lesser curvatures, respectively. The greater curvature, which begins at the ca ...

of the

stomach The stomach is a muscular, hollow organ in the upper gastrointestinal tract of Human, humans and many other animals, including several invertebrates. The Ancient Greek name for the stomach is ''gaster'' which is used as ''gastric'' in medical t ...

, is known as the dorsal mesogastrium. The part of the dorsal mesentery that suspends the colon is termed the

mesocolon In human anatomy, the mesentery is an organ that attaches the intestines to the posterior abdominal wall, consisting of a double fold of the peritoneum. It helps (among other functions) in storing fat and allowing blood vessels, lymphatics, ...

. The dorsal mesogastrium develops into the

Ventral mesentery

The development of the

septum transversum The septum transversum is a thick mass of cranial mesenchyme, formed in the embryo, that gives rise to parts of the thoracic diaphragm and the ventral mesentery of the foregut in the developed human being and other mammals. Origins The septum t ...

takes part in the formation of the

diaphragm Diaphragm may refer to: Anatomy * Thoracic diaphragm, a thin sheet of muscle between the thorax and the abdomen * Pelvic diaphragm or pelvic floor, a pelvic structure * Urogenital diaphragm or triangular ligament, a pelvic structure Other * Diap ...

, while the caudal portion into which the

grows forms the ventral mesentery. The part of the ventral mesentery that attaches to the

is known as the ventral mesogastrium.Gray's anatomy The

lesser omentum The lesser omentum (small omentum or gastrohepatic omentum) is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum. The lesser omentum is usually divided into t ...

is formed, by a thinning of the

mesoderm The mesoderm is the middle layer of the three germ layers that develops during gastrulation in the very early development of the embryo of most animals. The outer layer is the ectoderm, and the inner layer is the endoderm.Langman's Medical ...

or ventral mesogastrium, which attaches the stomach and

duodenum The duodenum is the first section of the small intestine in most vertebrates, including mammals, reptiles, and birds. In mammals, it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest p ...

to the anterior

abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the vi ...

. By the subsequent growth of the liver, this leaf of mesoderm is divided into two parts – the

between the stomach and liver, and the

falciform {{Short pages monitor