Normal anatomy and pathologic changes of the small bowel mesentery: US appearance

The ultrasonographic (US) appearance of the normal small bowel mesenteric leaves was evaluated in two in vitro studies and in 30 patients. Such structures had an elongated shape, echogenic surfaces, and small vessels in their center and could be recognized in 28 of the 30 patients. They did not show active movements, and at their distal end, the small bowel loops could be seen and peristalsis detected. Doppler signals were obtained from the small vascular structures in their center in three additional cases. On the basis of these anatomic findings, pathologic changes such as lymphoma, desmoid tumor, metastatic lesions, dilated vessels, and edema could be detected in 15 patients. When examining with US patients with diseases prone to involve the mesentery, careful attention should be given to this structure, since useful information about the abdominal spread of the disease can be obtained.