Mirrored Appearance of Complete Common Mesentery Discovered on CT Scan for Crohn's Disease
| Autor: | Mouna Sabiri, Fatima Zahra Badi, Oumar Djidda, Odette Ndikumana, Samia Elmanjra, Fatiha Essodegui, Samira Lezar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Abdominal cavity
rotation medicine.artery Internal Medicine medicine Superior mesenteric artery Mesentery colon business.industry Sigmoid colon Articles Anatomy medicine.disease digestive system diseases Small intestine crohn’s disease medicine.anatomical_structure Intestinal malrotation complete mirrored mesentery Duodenum Medicine Abdomen business small intestine abdomen |
| Zdroj: | European Journal of Case Reports in Internal Medicine (2021) Eur J Case Rep Intern Med |
| ISSN: | 2284-2594 |
| DOI: | 10.12890/2021_002721 |
| Popis: | Incomplete 90° intestinal rotation in a clockwise direction results in complete common mesentery being placed in a mirror image to and with a similar appearance to complete common mesentery. This rotation places the colon in the right half of the abdominal cavity and the small intestine in the left half of the abdominal cavity. We report the case of a 19-year-old patient with a history of cerebral palsy secondary to meningitis who presented with melaena and inflammatory anaemia. CT enterography was performed which showed regular, non-stenosing circumferential wall thickening of the sigmoid colon and rectosigmoid junction compatible with Crohn’s disease, which was confirmed by pathophysiology. It also revealed transposition of the colon to the right hemi-abdomen and the small intestine to the left hemi-abdomen, the caecum to the right iliac fossa, and the third portion of the duodenum to the left of the mesenteric vessels. LEARNING POINTS Complete common mesentery in the mirror image is an anomaly of intestinal rotation, placing the colon in the right half of the abdomen and the small intestine in the left half of the abdomen. It can be asymptomatic and discovered incidentally during assessment for other conditions. Keywords: Complete mirrored mesentery, rotation, colon, abdomen, small intestine, Crohn’s disease INTRODUCTION Anomalies of intestinal rotation result from the failure of normal embryological rotation and fixation of the primary intestinal loop during embryonic development. The underlying cause of this anomaly is abnormal rotation of the small intestine along the axis of the superior mesenteric artery and can occur at any stage of embryogenesis, involving a part of or the entire intestine [1]. Complete common mesentery in mirror image suggests a type of incomplete rotation where the intestine is rotated 90° clockwise, but has a similar appearance to complete common mesentery [2]. Intestinal malrotation in adults may be associated with irritable bowel syndrome or related minor abdominal symptoms [3]. We report a rare case of the mirrored appearance of complete common mesentery associated with Crohn’s disease diagnosed in adulthood. |
| Databáze: | OpenAIRE |
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