The mesenteric root space is the retroperitoneal region traversed by the root of the small bowel mesentery, running obliquely from the duodenojejunal flexure at L2 to the right iliac fossa. It contains the superior mesenteric vessels, lymphatics, and autonomic nerves supplying the small bowel and right colon.
The mesenteric root is the anatomical basis for mesenteric occlusion, where superior mesenteric artery thrombosis or embolism produces catastrophic small bowel ischaemia. CT angiography images the superior mesenteric vessels at the mesenteric root. Mesenteric root lymph nodes are the primary drainage basin for small bowel malignancy. Mesenteric root tethering in superior mesenteric artery syndrome (Wilkie's syndrome) compresses the third part of the duodenum.
Acute or chronic occlusion of the SMA at its mesenteric root origin producing catastrophic or progressive small bowel ischaemia requiring emergency revascularisation or bowel resection.
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