The mesentery (mesentery of the small intestine) is the broad, fan-shaped double fold of peritoneum that suspends the jejunum and ileum from the posterior abdominal wall. Its root is only about 15 cm long and runs obliquely from the duodenojejunal flexure on the left of L2 to the right sacroiliac region, while its intestinal border spreads along several metres of bowel. Between its layers lie fat, the jejunal and ileal vessels, lymph nodes, lacteals and nerves.
| Location | From its root on the posterior abdominal wall (left of L2 to the right sacroiliac joint) to the jejunum and ileum |
|---|---|
| Parts |
|
| Nerve Supply | Superior mesenteric plexus; Vagus nerve (parasympathetic) |
| Blood Supply | Superior mesenteric artery; Jejunal and ileal arteries; Ileocolic artery |
| Venous drainage |
|
| Lymphatic drainage |
|
Anchors the small intestine while allowing it to move, and carries its blood vessels, lymphatics and nerves.
Its narrow root lets the small bowel move freely, but in malrotation the root is very short and the gut can twist (midgut volvulus). The root crosses the third part of the duodenum, aorta, inferior vena cava, right ureter and right psoas, which are at risk in surgery here. Many surgeons now describe the mesentery as one continuous organ running from the duodenojejunal flexure to the mesorectum.
Sudden loss of blood flow through the mesenteric vessels from embolus, thrombosis or low flow, causing pain out of proportion to examination findings.
Rupture of the mesentery in blunt trauma, often from a seatbelt, causing bleeding and bowel ischaemia.
Chronic inflammation and fibrosis of mesenteric fat that can cause pain, a mass or bowel obstruction.
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