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The mesentery in Crohn's disease: friend or foe?

Coffey, John Calvin; O‘Leary, Donal Peter; Kiernan, Miranda G.; Faul, Peter

Current Opinion in Gastroenterology: July 2016 - Volume 32 - Issue 4 - p 267–273
doi: 10.1097/MOG.0000000000000280
INFLAMMATORY BOWEL DISEASE: Edited by Claudio Fiocchi

Purpose of review: This article assesses the role of the mesentery in Crohn's disease.

Recent findings: The mesentery is centrally positioned both anatomically and physiologically. Overlapping mesenteric and submucosal mesenchymal contributions are important in the pathobiology of Crohn's disease. Mesenteric contributions explain the topographic distribution of Crohn's disease in general and mucosal disease in particular. Operative strategies that are mesenteric based (i.e. mesocolic excision) may reduce rates of postoperative recurrence.

Summary: The net effect of mesenteric events in Crohn's disease is pathologic. This can be targeted by operative means.

Video abstract: http://links.lww.com/COG/A18.

aDepartment of Surgery, University Hospital Limerick

bGraduate Entry Medical School, University of Limerick

c4I Centre for Interventions in Infection, Inflammation and Immunity, University of Limerick

dDepartment of Pathology, University Hospital Limerick, Limerick, Ireland

Correspondence to Professor J. Calvin Coffey, PhD, FRCSI, Surgical Professorial Unit, University Hospital Limerick, Limerick, Ireland. Tel: +353 61 482412; fax: +353 61 482410; e-mail: calvin.coffey@ul.ie

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