Mesenteric hypertrophy

Fig. 7.5. Mesenteric hypertrophy, appearing at US as hyperechoic, sometimes inhomogeneous area surrounding thickened howel walls...

The US features of UC reflect the pathological aspects of the howel wall. The main abnormalities of the bowel wall include thickening, alterations of bowel wall echo pattern, hyperaemia and loss of haustra coli. Occasionally mesenteric hypertrophy and mesenteric nodes, or complications such as stenosis or toxic megacolon, can be found. 

Mesenteric hypertrophy Sometimes present Often present Often present... 

Salmonella enterica (S. enterica) is a rod-shaped Gram-negative facultative anaerobe and a prominent enteric bacterial pathogen capable of causing food- and water-related diseases. Several serovars of S. enterica are associated with human infection. The principle clinical diseases associated with Salmonella infection are typhoid fever and gastroenteritis. S. enterica serovars Typhi S. Typhi) and Paratyphi (,S. Paratyphi) are pathogenically exclusive for humans and are known to cause typhoid or enteric fever (Ohl and Miller, 2001). Typhoid fever is a systemic infection characterized by the development of fever, abdominal pain, enterocolitis, and occasionally, a maculopapular rash. The hallmark feature of typhoid fever is the presence of mononuclear cell infiltration and hypertrophy of the intestinal Peyer s patches and mesenteric lymphoidal tissue (Kraus et al., 1999 Ohl and Miller, 2001). There are approximately 20 million cases of typhoid fever worldwide each year, and this acute and often life-threatening infection is responsible for over 200,000 deaths annually (Crump et al., 2004). 

A necrotic small intestine was resected in a 65-year-old man with ergotamine abuse (29). Histological examination showed hypertrophy of the smooth muscle of the mesenteric arteries resulting from chronic vasospasm. The patient developed postoperatively hmb ischemia and tongue gangrene before he died. 

Elevated NGF concentrations have been seen in two conditions involving altered muscle morphology. Hypertrophy and hyperplasia of bladder smooth muscle cells induced by increased in-travesicular pressure elevates NGF content 2-fold (Steers et al., 1991), while, within the mesenteric artery of the SHR, a rise in NGF concentration correlates with the onset of smooth muscle hyperplasia (Zettler and Rush, 1993). Since abnormalities also occur within the innervation of both these pathologies, it is unclear whether the altered NGF concentrations result from changes in muscle or nerve function. 

The US manifestations of CD reflect the pathological features, consisting of abnormalities of bowel wall or representing its intra-abdominal complications. The abnormalities of bowel wall include bowel wall thickening, alterations of bowel wall echo pattern, hyper-aemia, loss of elasticity and peristalsis, mesentering hypertrophy and mesenteric lymph nodes. Intraabdominal complications of CD typically include stenoses and obstruction, fissures and fistulae, as well as inflammatory masses (phlegmon or abscesses). 

Fig. 10.2. US image showing a dilated small bowel loop with a thickened bowel wall with plical hypertrophy (arrow), and mesenteric oedema...

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