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# Mesoappendix

The mesoappendix is the small fold of tissue that holds the [appendix](https://durgical.com/en/anatomy/vermiform-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 points

- The appendicular artery, an end artery from the ileocolic, runs near its free edge; dividing and securing it is the key step of every appendectomy
- Inflamed, thickened fat in the mesoappendix is one of the main imaging signs of appendicitis

## 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](https://durgical.com/en/anatomy/ileum/) and the ileocecal fold (bloodless fold of Treves); the inferior ileocecal recess lies between that fold and the mesoappendix

**Contents**
[Appendicular artery](https://durgical.com/en/anatomy/appendicular-artery/) and vein, lymphatics draining to the ileocolic nodes, and nerves from the [superior mesenteric plexus](https://durgical.com/en/anatomy/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](https://durgical.com/en/anatomy/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](https://durgical.com/en/anatomy/region/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](https://durgical.com/en/anatomy/region/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

- [Acute appendicitis](https://durgical.com/en/conditions/acute-appendicitis/)

## 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.

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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

- [Appendix](https://durgical.com/en/anatomy/vermiform-appendix/)
- [Appendicular artery](https://durgical.com/en/anatomy/appendicular-artery/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Abdomen and Pelvis: Large Intestine](https://www.ncbi.nlm.nih.gov/books/NBK470577/); [Anatomy, Abdomen and Pelvis: Appendix](https://www.ncbi.nlm.nih.gov/books/NBK459205/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/mesoappendix/
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