Mesoappendix !
The mesoappendix is the small fold of tissue that holds the appendix and carries its artery; securing it is a key step in removing the appendix.
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What it is
The small fold that attaches the appendix and carries the appendicular artery.
What it does
Divided and sealed in an appendectomy.
Key facts
- Where
- Small triangular fold behind terminal ileum, from lower mesentery to the appendix
- Attaches
- Posterior side of mesentery of terminal ileum to whole length of appendix
- Function
- Carries appendicular artery and vein (in its free edge) and lymphatics
Relations
- In front
- Terminal ileum and the ileocecal fold (bloodless fold of Treves); the inferior ileocecal recess lies between that fold and the mesoappendix
- Contents
- Appendicular artery and vein, lymphatics draining to the ileocolic nodes, and nerves from the superior mesenteric plexus
How to find it
At appendectomy the appendix is lifted by its tip so the mesoappendix fans out as a triangle between the appendix, the cecum and the terminal ileum; the artery is seen in its free border and secured near the base or in steps (with ties, clips or an energy device in laparoscopy).
On imaging
On ultrasound the inflamed mesoappendix appears as bright, non-compressible fat around the appendix; on CT as fat stranding. An appendiceal abscess may form within it after perforation.
Common problems
- Peritonitis: infection or inflammation, usually from a burst organ (appendix, ulcer); severe pain and a rigid abdomen. An emergency.
How it is diagnosed
Examination, blood tests, CT.
Treatment
- Treat the source (often surgery) and antibiotics.
Clinical notes
- Bleeding after appendectomy usually comes from a slipped tie on the appendicular artery in the mesoappendix
- After perforation, pus spreads along the right paracolic gutter down into the pelvis or up to the hepatorenal pouch (Morison pouch)
Anatomical variants
- An accessory appendicular artery, usually from the posterior cecal artery, is described (some texts); missing it can cause bleeding
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Which artery runs in the mesoappendix?
The appendicular artery, an end artery from the ileocolic, near the free edge of the mesoappendix; dividing and securing it is the key step of appendectomy.
What is the usual source of bleeding after appendectomy?
A slipped tie on the appendicular artery in the mesoappendix.
What imaging sign in the mesoappendix supports appendicitis?
Inflamed, thickened fat: bright, non-compressible fat on ultrasound or fat stranding on CT around the appendix.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- mesoappendix TA2 3749
- Official Spanish (DeCS)
- Mesoapéndice
- English (TA2)
- Mesoappendix
- Also called
- mesenteriolum processus vermiformis
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Abdomen and Pelvis: Large Intestine; Anatomy, Abdomen and Pelvis: Appendix.
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Representative model, for educational purposes only.
