Creeping Fat in Crohn’s Disease—Surgical, Histological, and Radiological Approaches

Αγγελετοπούλου, Ιωάννα; Tsounis, Efthymios P; Mouzaki, Αthanasia; Triantos, Christos

doi:10.3390/jpm13071029

“…This 'creeping 'migration of fat generally occurs when there is bacterial translocation from the transmurally inflamed intestine into mesenteric fat, and this happens in an attempt to prevent bacterial spread into the bloodstream. Creeping fat infiltrated by immune cells is immunologically active and secretes various pro-inflammatory (tumor necrosis factor-alpha (TNFα), interleukin-(IL)-6 (IL-6) and IL-8) and anti-inflammatory cytokines and profibrotic factors, and is associated with the development of muscular propria hyperplasia and intestinal fibrosis [55]. Creeping fat is a landmark for surgeons to localize the inflamed intestine in CD [56].…”

Section: Mesenteric Fibrosis (Mf)mentioning

confidence: 99%

A New Organ: The Mesentery and Non-Vascular Mesenteric Diseases

Ahmed

2024

Preprint

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Mesentery was discovered as a new organ in 2017. It is a continuous membranous tissue from the duodenojejunal flexure to the anorectal junction. It has distinct anatomy, physiology, and disease states. Primary mesenteropathies include vascular and non-vascular diseases. Some of them are common, and some of them are rarely seen in clinical practice. Secondary mesenteropathies occur when infection or malignancy in another organ spreads to the mesentery. Each entity has specific diagnostic and treatment protocols.

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A novel computed tomography enterography radiomics combining intestinal and creeping fat features could predict surgery risk in patients with Crohn’s disease

Du,

Xu,

Qiu

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Objective The objective of this study is to segment creeping fat and intestinal wall on computed tomography enterography (CTE) and develop a radiomic model to predict 1-year surgery risk in patients with Crohn’s disease. Methods This retrospective study included 135 Crohn’s disease patients who underwent CTE between January and December 2021 (training cohort) and 69 patients between January and June 2022 (test cohort). A total of 1874 radiomic features were extracted from the intestinal wall and creeping fat respectively on the venous phase CTE images, and radiomic models were constructed based on the selected features using the Boruta and extreme gradient boosting algorithms. The combined models were established by integrating clinical predictors and radiomic models. The receiver operating characteristic curve, calibration curve, and decision curve analyses were used to compare the predictive performance of models. Results In the training and test cohorts, the area under the curve (AUC) values of the creeping fat radiomic model for surgery risk stratification were 0.916 and 0.822, respectively, similar to the intestinal model with AUC values of 0.889 and 0.822. Moreover, the combined radiomic model was superior to the single models, showing good discrimination with the highest AUC values (training cohort: 0.963; test cohort: 0.882). Addition of clinical predictors to the radiomic models failed to significantly improve the diagnostic ability. Conclusion The CTE-based creeping fat radiomic model provided additional information to the intestinal radiomic model, and their combined radiomic model enables accurate surgery risk prediction of Crohn’s disease patients within 1 year of CTE.

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A clinician’s perspective on the new organ mesentery and non-vascular mesenteropathies

Ahmed

2024

Front. Physiol.

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Mesentery was discovered as a new organ in 2017. It is a continuous membranous tissue from the duodenojejunal flexure to the anorectal junction. It has distinct anatomy, physiology, and disease states. Primary mesenteropathies include vascular and non-vascular diseases. Some of them are common, and some of them are rarely seen in clinical practice. Secondary mesenteropathies occur when infection or malignancy in another organ spreads to the mesentery. Each entity has specific diagnostic and treatment protocols. Increased awareness of different mesenteropathies and an understanding of their various presentations at different stages of life can help in early diagnosis and improved clinical outcomes.

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Creeping Fat in Crohn’s Disease—Surgical, Histological, and Radiological Approaches

Cited by 4 publications

References 112 publications

A New Organ: The Mesentery and Non-Vascular Mesenteric Diseases

A New Organ: The Mesentery and Non-Vascular Mesenteric Diseases

A novel computed tomography enterography radiomics combining intestinal and creeping fat features could predict surgery risk in patients with Crohn’s disease

A clinician’s perspective on the new organ mesentery and non-vascular mesenteropathies

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