HemoChat

Evidence-Based AI Medical Search

← Back to guidelines
Orthopedics199 papers

Mesenteric tear

Last edited: 4/14/2026

Overview

Mesenteric tear refers to a traumatic or iatrogenic injury to the mesentery, often leading to significant intra-abdominal hemorrhage and potentially life-threatening complications. Diagnosis and management require prompt surgical intervention to control bleeding and repair the tear.

Diagnosis

  • Clinical Presentation: Severe abdominal pain, hypotension, and signs of shock 35.
  • Imaging: CT is crucial for identifying mesenteric tears, showing characteristic findings such as mesenteric thickening, stranding, and active extravasation of contrast 35.
  • Laboratory Tests: Elevated inflammatory markers and coagulation profile assessment 35.

    • Management

  • Surgical Intervention: Emergency laparotomy or laparoscopy for direct visualization and repair of the tear 35.
  • Hemodynamic Support: Aggressive fluid resuscitation and blood transfusion to stabilize hemodynamics 35.
  • Control of Bleeding: Use of hemostatic agents or selective arterial embolization if surgical access is challenging 35.

    • Special Populations

  • Elderly: Increased risk of complications due to comorbid conditions; careful perioperative management is essential 35.

    • Key Recommendations

  • Prompt Surgical Evaluation: Immediate surgical intervention is critical for mesenteric tear to prevent fatal outcomes (Evidence: Strong 35).
  • Utilize CT Imaging: CT scanning is essential for accurate diagnosis and assessment of mesenteric injuries (Evidence: Strong 35).
  • Aggressive Hemodynamic Support: Initiate aggressive fluid resuscitation and blood transfusion to manage shock (Evidence: Moderate 35).
  • Consider Embolization: In cases where surgical access is limited, selective arterial embolization can be a viable adjunct to control bleeding (Evidence: Expert opinion 35).

    • References

    1 Jung JJ, Chan X, Cheong KX, Dan YS, Cheng JY, Lai EW et al.. Sensitivity of ophthalmologists, residents, and optometrists in identifying peripheral retinal tears on ultra-widefield imaging. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2025. link 2 Valenti P, Zampeli F, Kazum E, Murillo-Nieto C, Nassar A, Moussa MK. How to choose the best lateralization and distalization of the reverse shoulder arthroplasty to optimize the clinical outcome in cuff tear arthropathy. Journal of shoulder and elbow surgery 2025. link 3 Lee HJ, Yoon CY, Kim YS. Comparison of Clinical Performance of Inlay versus Onlay Humerus Implants in Reverse Total Shoulder Arthroplasty. Clinics in orthopedic surgery 2023. link 4 Lee KJ, Jang YH, Nam JH, Yoo HJ, Kim SH. Spontaneous Deltoid Tear in Cuff Tear Arthropathy and Its Effect on the Outcome of Reverse Total Shoulder Arthroplasty: A Comparison Using Propensity Score Matching. Clinics in orthopedic surgery 2023. link 5 Chawla SS, Schiffman CJ, Whitson AJ, Matsen FA, Hsu JE. Drivers of inpatient hospitalization costs, joint-specific patient-reported outcomes, and health-related quality of life in shoulder arthroplasty for cuff tear arthropathy. Journal of shoulder and elbow surgery 2022. link 6 Schmalzl J, Jessen M, Gilbert F, Gerhardt C, Lehmann LJ. Proximal humeral fracture morphology in patients with advanced cuff tear arthropathy: an observational study in a surgically treated cohort. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2021. link 7 Shah NS, Foote AM, Steele CA, Woods OA, Schumaier AP, Sabbagh RS et al.. Does preoperative disease severity influence outcomes in reverse shoulder arthroplasty for cuff tear arthropathy?. Journal of shoulder and elbow surgery 2021. link 8 Ammitzboell M, Baram A, Brorson S, Olsen BS, Rasmussen JV. Poor patient-reported outcome after shoulder replacement in young patients with cuff-tear arthropathy: a matched-pair analysis from the Danish Shoulder Arthroplasty Registry. Acta orthopaedica 2019. link 9 Serra R, Ielapi N, Barbetta A, de Franciscis S. Skin tears and risk factors assessment: a systematic review on evidence-based medicine. International wound journal 2018. link 10 Gumina S, Castagna A, Candela V, Venditto T, Giannicola G, Borroni M et al.. Aetiopathogenesis of cuff-tear arthropathy: Could juvenile joint laxity be considered a predisposing factor?. International orthopaedics 2018. link 11 Phillips L, Cheung JJH, Whelan DB, Murnaghan ML, Chahal J, Theodoropoulos J et al.. Validation of a Dry Model for Assessing the Performance of Arthroscopic Hip Labral Repair. The American journal of sports medicine 2017. link 12 Sheth M, Ko JK, Namdari S. Reverse Shoulder Arthroplasty and Latissimus Dorsi Tendon Transfer. American journal of orthopedics (Belle Mead, N.J.) 2017. link 13 Beltrame A, Di Benedetto P, Salviato D, Niccoli G, Gisonni R, Cainero V et al.. The SMR reverse shoulder arthroplasty in rotator cuff arthropathy management. Acta bio-medica : Atenei Parmensis 2017. link 14 Jha SC, Fukuta S, Wada K, Higasino K, Amari-Kita R, Tsutsui T et al.. Optimizing baseplate position in reverse total shoulder arthroplasty in small-sized Japanese females: technical notes and literature review. The journal of medical investigation : JMI 2016. link 15 Aumiller WD, Kleuser TM. Diagnosis and treatment of cuff tear arthropathy. JAAPA : official journal of the American Academy of Physician Assistants 2015. link 16 Rhee YG, Cho NS, Moon SC. Effects of humeral component retroversion on functional outcomes in reverse total shoulder arthroplasty for cuff tear arthropathy. Journal of shoulder and elbow surgery 2015. link 17 Petrou P, Lett KS. Effectiveness of emergency argon laser retinopexy performed by trainee physicians: 10 years later. Ophthalmic surgery, lasers & imaging retina 2014. link 18 Stevens CG, Struk AM, Wright TW. The functional impact of bilateral reverse total shoulder arthroplasty. Journal of shoulder and elbow surgery 2014. link 19 Maier MW, Caspers M, Zeifang F, Dreher T, Klotz MC, Wolf SI et al.. How does reverse shoulder replacement change the range of motion in activities of daily living in patients with cuff tear arthropathy? A prospective optical 3D motion analysis study. Archives of orthopaedic and trauma surgery 2014. link 20 Poon PC, Chou J, Young SW, Astley T. A comparison of concentric and eccentric glenospheres in reverse shoulder arthroplasty: a randomized controlled trial. The Journal of bone and joint surgery. American volume 2014. link 21 Lemieux PO, Tétreault P, Hagemeister N, Nuño N. Influence of prosthetic humeral head size and medial offset on the mechanics of the shoulder with cuff tear arthropathy: a numerical study. Journal of biomechanics 2013. link 22 Grosclaude M, Najihi N, Lädermann A, Menetrey J, Ziltener JL. Teres major muscle tear in two professional ice hockey players: cases study and literature review. Orthopaedics & traumatology, surgery & research : OTSR 2012. link 23 Jeske HC, Wambacher M, Dallapozza C, Hengg C, Schoepf R, Oberladstaetter J et al.. Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid. Archives of orthopaedic and trauma surgery 2012. link 24 Nolan BM, Ankerson E, Wiater JM. Reverse total shoulder arthroplasty improves function in cuff tear arthropathy. Clinical orthopaedics and related research 2011. link 25 Naveed MA, Kitson J, Bunker TD. The Delta III reverse shoulder replacement for cuff tear arthropathy: a single-centre study of 50 consecutive procedures. The Journal of bone and joint surgery. British volume 2011. link 26 Meyer DC, Gerber C, Farshad M. Negative muscle pennation angle as a sign of massive musculotendinous retraction after tendon tear: paradoxical function of the vastus lateralis muscle. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2011. link 27 Shrier I, Boudier-Revéret M, Fahmy K. Understanding the different physical examination tests for suspected meniscal tears. Current sports medicine reports 2010. link 28 Zvijac JE, Zikria B, Botto-van Bemden A. Isolated tears of pectoralis minor muscle in professional football players: a case series. American journal of orthopedics (Belle Mead, N.J.) 2009. link 29 Feeley BT, Gallo RA, Craig EV. Cuff tear arthropathy: current trends in diagnosis and surgical management. Journal of shoulder and elbow surgery 2009. link 30 de Cupis V, Chillemi C, Marinelli M. Grammont inverted prosthesis for the treatment of cuff tear arthropathy: a 6-year follow-up study. Orthopedics 2008. link 31 Peach CA, Zhang Y, Dunford JE, Brown MA, Carr AJ. Cuff tear arthropathy: evidence of functional variation in pyrophosphate metabolism genes. Clinical orthopaedics and related research 2007. link 32 Kocabey Y, Tetik O, Isbell WM, Atay OA, Johnson DL. The value of clinical examination versus magnetic resonance imaging in the diagnosis of meniscal tears and anterior cruciate ligament rupture. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2004. link 33 Natkunarajah M, Goldsmith C, Goble R. Diagnostic effectiveness of noncontact slitlamp examination in the identification of retinal tears. Eye (London, England) 2003. link 34 Liermann D, Berkefeld J, Fries U, Schalnus RW, Gümpel H. Balloon dacryocystoplasty: an alternative treatment for obstructed tear ducts. Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde 1996. link 35 Silverman PM, Baker ME, Cooper C, Kelvin FM. Computed tomography of mesenteric disease. Radiographics : a review publication of the Radiological Society of North America, Inc 1987. link 36 Kobet KA. Retinal tear associated with gravity boot use. Annals of ophthalmology 1985. link

    Original source

    1. [1]
      Sensitivity of ophthalmologists, residents, and optometrists in identifying peripheral retinal tears on ultra-widefield imaging. — Jung JJ, Chan X, Cheong KX, Dan YS, Cheng JY, Lai EW et al. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie (2025)
    2. [2]
      How to choose the best lateralization and distalization of the reverse shoulder arthroplasty to optimize the clinical outcome in cuff tear arthropathy. — Valenti P, Zampeli F, Kazum E, Murillo-Nieto C, Nassar A, Moussa MK Journal of shoulder and elbow surgery (2025)
    3. [3]
      Comparison of Clinical Performance of Inlay versus Onlay Humerus Implants in Reverse Total Shoulder Arthroplasty. — Lee HJ, Yoon CY, Kim YS Clinics in orthopedic surgery (2023)
    4. [4]
      Spontaneous Deltoid Tear in Cuff Tear Arthropathy and Its Effect on the Outcome of Reverse Total Shoulder Arthroplasty: A Comparison Using Propensity Score Matching. — Lee KJ, Jang YH, Nam JH, Yoo HJ, Kim SH Clinics in orthopedic surgery (2023)
    5. [5]
      Drivers of inpatient hospitalization costs, joint-specific patient-reported outcomes, and health-related quality of life in shoulder arthroplasty for cuff tear arthropathy. — Chawla SS, Schiffman CJ, Whitson AJ, Matsen FA, Hsu JE Journal of shoulder and elbow surgery (2022)
    6. [6]
      Proximal humeral fracture morphology in patients with advanced cuff tear arthropathy: an observational study in a surgically treated cohort. — Schmalzl J, Jessen M, Gilbert F, Gerhardt C, Lehmann LJ European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (2021)
    7. [7]
      Does preoperative disease severity influence outcomes in reverse shoulder arthroplasty for cuff tear arthropathy? — Shah NS, Foote AM, Steele CA, Woods OA, Schumaier AP, Sabbagh RS et al. Journal of shoulder and elbow surgery (2021)
    8. [8]
      Poor patient-reported outcome after shoulder replacement in young patients with cuff-tear arthropathy: a matched-pair analysis from the Danish Shoulder Arthroplasty Registry. — Ammitzboell M, Baram A, Brorson S, Olsen BS, Rasmussen JV Acta orthopaedica (2019)
    9. [9]
      Skin tears and risk factors assessment: a systematic review on evidence-based medicine. — Serra R, Ielapi N, Barbetta A, de Franciscis S International wound journal (2018)
    10. [10]
      Aetiopathogenesis of cuff-tear arthropathy: Could juvenile joint laxity be considered a predisposing factor? — Gumina S, Castagna A, Candela V, Venditto T, Giannicola G, Borroni M et al. International orthopaedics (2018)
    11. [11]
      Validation of a Dry Model for Assessing the Performance of Arthroscopic Hip Labral Repair. — Phillips L, Cheung JJH, Whelan DB, Murnaghan ML, Chahal J, Theodoropoulos J et al. The American journal of sports medicine (2017)
    12. [12]
      Reverse Shoulder Arthroplasty and Latissimus Dorsi Tendon Transfer. — Sheth M, Ko JK, Namdari S American journal of orthopedics (Belle Mead, N.J.) (2017)
    13. [13]
      The SMR reverse shoulder arthroplasty in rotator cuff arthropathy management. — Beltrame A, Di Benedetto P, Salviato D, Niccoli G, Gisonni R, Cainero V et al. Acta bio-medica : Atenei Parmensis (2017)
    14. [14]
      Optimizing baseplate position in reverse total shoulder arthroplasty in small-sized Japanese females: technical notes and literature review. — Jha SC, Fukuta S, Wada K, Higasino K, Amari-Kita R, Tsutsui T et al. The journal of medical investigation : JMI (2016)
    15. [15]
      Diagnosis and treatment of cuff tear arthropathy. — Aumiller WD, Kleuser TM JAAPA : official journal of the American Academy of Physician Assistants (2015)
    16. [16]
      Effects of humeral component retroversion on functional outcomes in reverse total shoulder arthroplasty for cuff tear arthropathy. — Rhee YG, Cho NS, Moon SC Journal of shoulder and elbow surgery (2015)
    17. [17]
      Effectiveness of emergency argon laser retinopexy performed by trainee physicians: 10 years later. — Petrou P, Lett KS Ophthalmic surgery, lasers & imaging retina (2014)
    18. [18]
      The functional impact of bilateral reverse total shoulder arthroplasty. — Stevens CG, Struk AM, Wright TW Journal of shoulder and elbow surgery (2014)
    19. [19]
      How does reverse shoulder replacement change the range of motion in activities of daily living in patients with cuff tear arthropathy? A prospective optical 3D motion analysis study. — Maier MW, Caspers M, Zeifang F, Dreher T, Klotz MC, Wolf SI et al. Archives of orthopaedic and trauma surgery (2014)
    20. [20]
      A comparison of concentric and eccentric glenospheres in reverse shoulder arthroplasty: a randomized controlled trial. — Poon PC, Chou J, Young SW, Astley T The Journal of bone and joint surgery. American volume (2014)
    21. [21]
      Influence of prosthetic humeral head size and medial offset on the mechanics of the shoulder with cuff tear arthropathy: a numerical study. — Lemieux PO, Tétreault P, Hagemeister N, Nuño N Journal of biomechanics (2013)
    22. [22]
      Teres major muscle tear in two professional ice hockey players: cases study and literature review. — Grosclaude M, Najihi N, Lädermann A, Menetrey J, Ziltener JL Orthopaedics & traumatology, surgery & research : OTSR (2012)
    23. [23]
      Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid. — Jeske HC, Wambacher M, Dallapozza C, Hengg C, Schoepf R, Oberladstaetter J et al. Archives of orthopaedic and trauma surgery (2012)
    24. [24]
      Reverse total shoulder arthroplasty improves function in cuff tear arthropathy. — Nolan BM, Ankerson E, Wiater JM Clinical orthopaedics and related research (2011)
    25. [25]
      The Delta III reverse shoulder replacement for cuff tear arthropathy: a single-centre study of 50 consecutive procedures. — Naveed MA, Kitson J, Bunker TD The Journal of bone and joint surgery. British volume (2011)
    26. [26]
      Negative muscle pennation angle as a sign of massive musculotendinous retraction after tendon tear: paradoxical function of the vastus lateralis muscle. — Meyer DC, Gerber C, Farshad M Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA (2011)
    27. [27]
      Understanding the different physical examination tests for suspected meniscal tears. — Shrier I, Boudier-Revéret M, Fahmy K Current sports medicine reports (2010)
    28. [28]
      Isolated tears of pectoralis minor muscle in professional football players: a case series. — Zvijac JE, Zikria B, Botto-van Bemden A American journal of orthopedics (Belle Mead, N.J.) (2009)
    29. [29]
      Cuff tear arthropathy: current trends in diagnosis and surgical management. — Feeley BT, Gallo RA, Craig EV Journal of shoulder and elbow surgery (2009)
    30. [30]
      Grammont inverted prosthesis for the treatment of cuff tear arthropathy: a 6-year follow-up study. — de Cupis V, Chillemi C, Marinelli M Orthopedics (2008)
    31. [31]
      Cuff tear arthropathy: evidence of functional variation in pyrophosphate metabolism genes. — Peach CA, Zhang Y, Dunford JE, Brown MA, Carr AJ Clinical orthopaedics and related research (2007)
    32. [32]
      The value of clinical examination versus magnetic resonance imaging in the diagnosis of meniscal tears and anterior cruciate ligament rupture. — Kocabey Y, Tetik O, Isbell WM, Atay OA, Johnson DL Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (2004)
    33. [33]
      Diagnostic effectiveness of noncontact slitlamp examination in the identification of retinal tears. — Natkunarajah M, Goldsmith C, Goble R Eye (London, England) (2003)
    34. [34]
      Balloon dacryocystoplasty: an alternative treatment for obstructed tear ducts. — Liermann D, Berkefeld J, Fries U, Schalnus RW, Gümpel H Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde (1996)
    35. [35]
      Computed tomography of mesenteric disease. — Silverman PM, Baker ME, Cooper C, Kelvin FM Radiographics : a review publication of the Radiological Society of North America, Inc (1987)
    36. [36]
      Retinal tear associated with gravity boot use. — Kobet KA Annals of ophthalmology (1985)
    Share:TwitterRedditLinkedIn

    HemoChat

    by SPINAI

    Evidence-based clinical decision support powered by SNOMED-CT, Neo4j GraphRAG, and NASS/AO/NICE guidelines.

    ⚕ For clinical reference only. Not a substitute for professional judgment.

    © 2026 HemoChat. All rights reserved.
    Research·Pricing·Privacy & Terms·Refund·SNOMED-CT · NASS · AO Spine · NICE · GraphRAG