Masses Within the Mesocolic Leaves

Pathologic alteration in the contour of the duodenum by a localized abnormality arising in the origin of the reflections of the transverse mesocolon is shown in Figure 10-10. The bare area is widest at this site so that symmetric growths developing within the leaves may impress upon the duodenum over a considerable length. The typical points of pressure then are at the immediate infraampullary and the genu locations.

Antecolic Loop Gastrojejunostomy

Fig. 10-8. The transverse mesocolon (arrows) is outlined by the limitation of cephalad extension of jejunal loops posterior to the transverse colon, resulting in flattening of their superior contour. It corresponds to a line drawn from the mid-descending duodenum to the duodenojejunal junction.

(a) Normal gastrointestinal series.

(b) Post-Billroth II antecolic gastrojejunostomy.

(c) Postduodenojejunostomy. (Reproduced from Meyers and Whalen.1)

Fig. 10-8. The transverse mesocolon (arrows) is outlined by the limitation of cephalad extension of jejunal loops posterior to the transverse colon, resulting in flattening of their superior contour. It corresponds to a line drawn from the mid-descending duodenum to the duodenojejunal junction.

(a) Normal gastrointestinal series.

(b) Post-Billroth II antecolic gastrojejunostomy.

(c) Postduodenojejunostomy. (Reproduced from Meyers and Whalen.1)

Lesser Sac Radiology

Fig. 10—9. Internal hernia into the lesser sac through a large defect in the transverse mesocolon.

This is indicated by the high position of the loops of small bowel above the normal insertion of the transverse mesocolon, which no longer determines their contour.

(b) Prone oblique. Note that the herniated loops present posterior to the transverse colon and stomach. (Reproduced from Meyers and Whalen.1)

Fig. 10—9. Internal hernia into the lesser sac through a large defect in the transverse mesocolon.

This is indicated by the high position of the loops of small bowel above the normal insertion of the transverse mesocolon, which no longer determines their contour.

(b) Prone oblique. Note that the herniated loops present posterior to the transverse colon and stomach. (Reproduced from Meyers and Whalen.1)

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