AB065. 229. On the growth and form of the mesentery
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AB065. 229. On the growth and form of the mesentery

Kevin G. Byrnes1,2, Dara Walsh1,2, M. Fahad Ullah1, Omer Hashmi1, Daniel Westby1, Anna Garritt3, Rosa Mirapeix3, Wout Lamers4,5, Yi Wu7, S. Xiang Zhang7, Fabio Quondamatteo8, Peter Dockery8, Kieran W. McDermott2, J. Calvin Coffey1,2,8; Human Mesentery Project Consortium

1University Hospital Limerick, Limerick, Ireland; 2Department of Anatomy, Graduate Entry Medical School, University of Limerick, Limerick, Ireland; 3Department of Embryology, Universitat Autònoma de Barcelona, Barcelona, Spain; 4Department of Anatomy & Embryology, Maastricht University, Maastricht, the Netherlands; 5Tygat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, Netherlands; 6Department of Anatomy and Embryology, Chongqing Medical University, Chongqing 400016, China; 7Department of Anatomy, National University of Ireland, Galway, Ireland; 84i Centre for Interventions in Infection, Inflammation & Immunity, University of Limerick, Limerick, Ireland

Background: Systematic study of the mesentery has demonstrated that it is both continuous and spiral in nature from duodenum to rectum. Embryological planes are commonly exploited during abdominal surgery; however, the exact morphogenesis of the mesentery remains unknown. This study aimed to characterise the three-dimensional structure of the developing mesentery.

Methods: Embryological (n=12), foetal (n=4) and cadaveric (n=2) specimens were sectioned, stained and digitized. Regression analysis (SIFT; ImageJ2, v1.50e, NIH, USA) stacked sections in their true alignment. An internal panel of two reviewers verified manual tracings of regional anatomy and performed a double-blinded comparison of age-matched embryos. To test the reliability of manual tracing, five operators independently traced developing structures. Findings from three-dimensional outputs were further investigated with cadaveric dissection.

Results: Areas of mesoderm, endoderm and vasculature were reliably traced by operators [intra-class correlation coefficients 0.999 (95% CI, 0.998–0.999), 0.976 (95% CI, 0.938–0.994), and 0.995 (95% CI, 0.988–0.999) respectively]. Rendered volumes had a high degree of spatial overlap between operators [Sørensen-Dice similarity coefficient (mean ± SD) of mesoderm 0.9949±0.0085 (0.994–0.996), endoderm 0.9224±0.0067 (0.91–0.931), and vasculature 0.9379±0.00365 (0.933–0.944)]. Bland-Altman analysis demonstrated no systematic bias between operators. Three-dimensional visualisation of fore-, mid- and hindgut regions of the mesentery enabled identification of continuity between all regions in every specimen. Cadaveric dissection replicated three-dimensional observations.

Conclusions: The mesentery, continuous from mesogastric to mesorectal level, is the exclusive intermediate between viscera and the remainder of the body. This developmental model provides a structural framework for understanding and further investigating visceral and neurovascular development.

Keywords: Mesentery; embryology; development

doi: 10.21037/map.2018.AB065

Cite this abstract as: Byrnes KG, Walsh D, Ullah MF, Hashmi O, Westby D, Garritt A, Mirapeix R, Lamers W, Wu Y, Zhang SX, Quondamatteo F, Dockery P, McDermott KW, Coffey JC; Human Mesentery Project Consortium. On the growth and form of the mesentery. Mesentery Peritoneum 2018;2:AB065. doi: 10.21037/map.2018.AB065