Mirrored Appearance of Complete Common Mesentery Discovered on CT Scan for Crohn's Disease

Abstract

Incomplete 90° intestinal rotation in a clockwise direction results in complete common mesentery being placed in a mirror image to and with a similar appearance to complete common mesentery. This rotation places the colon in the right half of the abdominal cavity and the small intestine in the left half of the abdominal cavity. We report the case of a 19-year-old patient with a history of cerebral palsy secondary to meningitis who presented with melaena and inflammatory anaemia. CT enterography was performed which showed regular, non-stenosing circumferential wall thickening of the sigmoid colon and rectosigmoid junction compatible with Crohn's disease, which was confirmed by pathophysiology. It also revealed transposition of the colon to the right hemi-abdomen and the small intestine to the left hemi-abdomen, the caecum to the right iliac fossa, and the third portion of the duodenum to the left of the mesenteric vessels.

Co-Existence of An Unusual Branching Pattern of Celiacomesenteric Trunk With Complete Common Mesentery in a 48-Year-Old Man: A Case Report

“…Furthermore, besides this uncommon branching pattern, this case evidenced the co-existence of a complete common mesentery, which to the best of our knowledge is the first case evidencing the co-occurrence of both. Complete common mesentery is an anomaly of intestinal rotation that results from the failure of normal embryological rotation and fixation of the primary intestinal loop during embryonic development ( Ndikumana et al, 2021 ). Midgut malrotation in adults is uncommon with a reported occurrence of 0.0001% to 0.19% in adults ( Ndikumana et al, 2021 ).…”

“…Complete common mesentery is an anomaly of intestinal rotation that results from the failure of normal embryological rotation and fixation of the primary intestinal loop during embryonic development ( Ndikumana et al, 2021 ). Midgut malrotation in adults is uncommon with a reported occurrence of 0.0001% to 0.19% in adults ( Ndikumana et al, 2021 ). The complete common mesentery represents an abnormal rotation of the primary intestinal loop at 90° ( Oudou et al, 2019 ).…”

“…Under such condition, all small bowel will be located on the right and the colon will entirely be located on the left ( El Mortaji et al, 2019 ). The cecum takes an anterior and middle position, and the SMA will be on the right of the superior mesenteric vein ( Ndikumana et al., 2021 ). This anomaly is usually asymptomatic and is subject to increasing incidental discovery thanks to the increasing use of imaging techniques.…”