Mesenteric Resection in Crohn’s Disease

While current armamentarium of medications play a substantial role in Crohn’s disease (CD) remission and maintenance, a still significant number of patients will require operative intervention when their disease is refractory to medical treatment, progress while on medications, develop complications or become end stage fistulizing and/or stricturing disease. CD is mainly an intestinal disease. However, recent interest in the bowel mesentery in general, and especially in the extra-intestinal mesenteric manifestations that is tightly coupled with intestinal pathological features drew the attention to a potential role of the mesentery in CD. It has been proposed that the bowel mesentery has its own substantive anatomic entity, as well as physiologic distinctiveness that it is no longer regarded as bystander tissue in human body. Being highly involved and active in local and systemic inflammatory response increased its recognition of centrality in homeostasis in disease process.