Chronic abdominal pain associated with total mesentery agenesis

Dolor abdominal crónico asociado con agenesia total de mesenterio

Mesenteric agenesis is a rare anomaly often not suspected in a child presenting with chronic abdominal pain. Several cases of mesenteric, bowel and upper mesenteric artery agenesis in association with bowel atresia have been reported. Herein, we report a child with total mesenteric agenesis presenting with ileal volvulus and bowel malrotation. Chronic abdominal pain is one the most common complaints in children presenting for emergency care evaluation. The etiologies are multiple but a timely diagnosis is necessary to prevent fatal outcomes

1. Sadler. Embriología médica-Langman. 12, editor 2012.
2. Arthur F, Carachi R. Malrotation in infancy and childhood. Scott Med J. 2016;61(2):69-73.
3. Langer JC. Intestinal Rotation Abnormalities and Midgut Volvulus. Surg Clin North Am. 2017;97(1):147-59.
4. Pumberger W, Birnbacher R, Pomberger G, Deutinger J. Duodeno-jejunal atresia with volvulus, absent dorsal mesentery, and absent superior mesenteric artery: a hereditary compound structure in duodenal atresia? Am J Med Genet. 2002;109(1):52-5.
5. Black PR, Mueller D, Crow J, Morris RC, Husain AN. Mesenteric defects as a cause of intestinal volvulus without malrotation and as the possible primary etiology of intestinal atresia. J Pediatr Surg. 1994;29(10):1339-43.
6. Benyamini P, Lopez S, Cooper M, Mohamad O, Maldini G. Congenital Mesenteric Defect: An Uncommon Cause of Bowel Obstruction. Hawaii J Med Public Health. 2016;75(2):46-7.
7. Herman TE, Siegel MJ. Apple peel small bowel. J Perinatol. 2008;28(5):380-2.
8. Blandy J. Neonatal intestinal obstruccion from a congenital hole in the mesentery. Br J surg [Internet]. 1960; 48:[133 p.].
9. Cascio S, Tien AS, Agarwal P, Tan HL. Dorsal mesenteric agenesis without small bowel atresia: a rare cause of midgut volvulus in children. J Pediatr Surg. 2006;41(9):E5-7.
10. Hull JD, 3rd, Kiesel JL, Proudfoot WH, Belin RP. Agenesis of the dorsal mesentery without jejunoilial atresia ("apple peel small bowel"). J Pediatr Surg. 1975;10(2):277-9.
11. Llore N, Tomita S. Apple peel deformity of the small bowel without atresia in a congenital mesenteric defect. J Pediatr Surg. 2013;48(1):e9-11.
12. Madani S, Parikh S, Madani RS, Krasaelap A. Long-Term Study of Children With ROME III Functional Gastrointestinal Disorders Managed Symptomatically in a Biopsychosocial Model. Gastroenterology Research. 2017;10(2):84-91.
13. Rodríguez G L, Faúndez H R, Maure O D. Dolor Abdominal Crónico en pediatría. Revista chilena de pediatría. 2012;83:279-89.
14. Ferrero L, Ahmed YB, Philippe P, Reinberg O, Lacreuse I, Schneider A, et al. Intestinal Malrotation and Volvulus in Neonates: Laparoscopy Versus Open Laparotomy. J Laparoendosc Adv Surg Tech A. 2017;27(3):318-21.