Mesenteric lymph nodes !
The mesenteric nodes are lymph nodes in the mesentery and along the colon's arteries; they filter lymph from the bowel and are removed in colon cancer surgery.
Official name: Superior mesenteric nodes
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What it is
Lymph nodes in the mesentery and along the colic vessels (ileocolic, appendicular, colic, sigmoid).
What it does
Filter lymph from the intestines. Swollen ones in children (mesenteric adenitis) can mimic appendicitis.
Key facts
- Where
- Superior mesenteric: along jejunal/ileal vessels in mesentery to SMA root; inferior mesenteric: at IMA origin; colon via paracolic and colic nodes
- Drains
- Small intestine, colon and upper rectum
- Into
- Intestinal trunk, then cisterna chyli; inferior mesenteric nodes partly to lumbar nodes
Relations
- Course
- Lymph from the intestinal lacteals passes through nodes beside the bowel, along the arterial arcades and at the root of the mesentery, then into the intestinal trunk and the cisterna chyli
- Above
- Central superior mesenteric nodes at the root of the mesentery, around the superior mesenteric artery origin behind the neck of the pancreas
- Below
- Inferior mesenteric nodes on the aorta at the inferior mesenteric artery origin (about L3), left of the midline; below them, the nodes of the mesorectum
How to find it
In colon surgery they are removed with the mesentery along the supplying artery up to its origin (central or high tie). In the small bowel they lie in the mesentery between the jejunal and ileal arteries and, when enlarged, are felt at surgery as firm nodules in the mesentery.
On imaging
On CT normal mesenteric nodes are small and oval; nodes over about 1 cm in short axis, clustered, necrotic or calcified are abnormal. Necrotic nodes with an enhancing rim suggest tuberculosis.
Common problems
- Cancers of the stomach and pancreas spread to them; surgeons remove them with the tumour.
Clinical notes
- Abdominal tuberculosis, relevant in Colombia, often involves the ileocaecal region and its mesenteric nodes, which can caseate, mat together or calcify
- Blockage of these nodes or the intestinal trunk by lymphoma, tuberculosis or cancer can cause chylous ascites
- High ligation of the inferior mesenteric artery in rectal cancer surgery removes the apical (central) node with the specimen
- Mesenteric node spread changes the stage of colorectal cancer and the need for chemotherapy
Related conditions
- Whipple disease
- Non-Hodgkin lymphoma
- Typhoid (enteric) fever
- Common variable immunodeficiency (CVID)
- Colorectal cancer
- Crohn disease
- Coeliac disease
- Acute (viral) gastroenteritis
Test yourself
Think of the answer, then tap the question to see it.
What are the tiers of lymph nodes draining the colon?
Epicolic, paracolic, intermediate (along the colic arteries) and central (at the origin of the superior or inferior mesenteric artery).
How many lymph nodes are usually examined for reliable staging of colon cancer?
At least 12, removed with the nodes along the supplying arteries.
What does the CT sandwich sign suggest?
Lymphoma: bulky mesenteric nodes surrounding the mesenteric vessels.
Which condition of swollen mesenteric nodes in children can mimic appendicitis?
Mesenteric adenitis.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- nodi mesenterici superiores TA2 5302
- Official Spanish (DeCS)
- Nódulos linfáticos mesentéricos superiores DeCS D008198
- English (TA2)
- Superior mesenteric nodes
- Also called
- lymphonodi mesosteniales
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis: Lymphatic Drainage.
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Representative model, for educational purposes only.
