Radiographics. 2016 Mar-Apr;36(2):412-3. doi: 10.1148/rg.2016150186.
Nougaret S1, Lakhman Y1, Reinhold C1, Addley HC1, Fujii S1, Delhom E1, Guiu B1, Sala E1.
The small bowel mesentery is a large fan-shaped fold of the peritoneum that suspends the small intestines and attaches them to the posterior wall of the abdomen. The small bowel mesentery can be represented schematically as a wagon wheel. The rim of the wheel is the small bowel. The spokes of the wheel are two peritoneal reflections that contain blood vessels, lymph nodes, lymphatic channels, and abundant fat. The center is the root of the small bowel mesentery that encompasses the superior mesenteric artery and the superior mesenteric vein and extends diagonally from the ligament of Treitz down to the ileocecal region.
Primary mesenteric neoplasms are uncommon. Most of these lesions originate from the mesenchyme, and the majority are benign. In contrast, secondary involvement of the small bowel mesentery is frequent, and most of the masses are malignant at histopathologic examination. Tumors that arise elsewhere in the abdomen can reach and spread through “spokes of the mesenteric wheel” by direct tumor extension, dissemination via lymphatic channels, embolic hematogenous spread, intraperitoneal seeding, or a combination of these routes (Figs 1, 2).