Overview
The universal mesentery is a congenital anomaly where the small intestine is suspended by a single mesentery, rather than the typical arrangement where the small intestine is suspended by a mesentery that is fused to the posterior abdominal wall. This anatomical variation can predispose individuals to certain gastrointestinal complications.Diagnosis
Diagnosis is typically made incidentally during abdominal imaging or surgery for other conditions.
Imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI) can reveal the characteristic single mesenteric root.Management
Management is generally conservative and depends on the presence of complications.
Asymptomatic individuals usually require no specific management.
Symptomatic individuals may require surgical intervention for complications such as malrotation, volvulus, or internal hernias.Key Recommendations
The preparticipation physical evaluation (PPE) is widely accepted but lacks standardization in its usage and content 1.
A history and physical exam focusing on cardiac risk is essential in PPE, and electrocardiogram (ECG) screening should be used where risk is increased 1.
Electronic PPE could provide a comprehensive database and simplify administration, allowing for much-needed data for prospective studies 1.References
1 Roberts WO, Löllgen H, Matheson GO, Royalty AB, Meeuwisse WH, Levine B et al.. Advancing the preparticipation physical evaluation: an ACSM and FIMS joint consensus statement. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2014. link