Primary mesenteric tumor

　　Primary mesenteric solid tumors can originate from any cell component of the mesentery, such as mesothelioma originating from mesenteric epithelial cells, mesenteric lymphangioma, and hard fibroma originating from fibroblasts.

　　Cysts include serous cysts, cystic lymphangioma, cavernous lymphangioma, chylous cysts, hemorrhagic cysts, dermoid cysts; benign tumors include leiomyomas, benign angioendothelioma and angioendothelioma, neurofibroma, lipoma, fibroma or fibroma disease, teratoma, giant cell granuloma due to foreign bodies. Among all types of tumors, serous cysts, fibromas, and leiomyomas are more common, and they can occur at any age, with little difference between men and women. Cysts can be as large as 10-20 cm without clinical symptoms, but multicystic cysts, with lymph fluid inside, are called chylous cysts if they contain chylous fluid, and hemorrhagic cysts if they are hemorrhagic.

　　Primary malignant mesenteric tumors include leiomyosarcoma, rhabdomyosarcoma, fibrosarcoma, liposarcoma, malignant angioendothelioma, yellow granuloma, reticulum cell sarcoma, lymphosarcoma, Hodgkin's disease, carcinosarcoma, adenocarcinoma, neurofibroma malignancy, malignant lipolipoma, and mesothelioma.

　　Primary mesenteric tumors with hemorrhage or spontaneous rupture can cause acute peritonitis, with severe pain symptoms. Malignant tumors that have invaded the intestinal tract can cause intestinal bleeding and hematochezia. Tumor compression of the inferior vena cava or iliac vein can lead to ascites, varicose veins of the abdominal wall, and lower limb edema. Tumor invasion of the liver can cause jaundice, abnormal liver function, and clay-colored stools. Tumor compression of the pancreas can lead to elevated and decreased blood sugar levels, and can also cause acute intestinal obstruction due to intestinal obstruction.

　　If benign tumors can be completely resected, the prognosis is good. If they are not completely resected or resected incompletely, certain tumors such as lipomas, fibromas, and leiomyomas may have a recurrence possibility. If it is a malignant tumor, there may be metastasis.

　　Primary mesenteric tumors are difficult to diagnose before surgery, and the final diagnosis relies on surgery and pathological examination. Clinical manifestations also vary greatly due to the size, nature, and growth speed of the tumor, with benign tumors often showing no clinical symptoms. The clinical symptoms of large tumors are often due to compression of adjacent organs by the mass.

　　1. Abdominal mass:Mostly painless masses, patients touch them unintentionally. If the patient does not pay enough attention, it is often delayed in diagnosis and treatment. When the mass grows larger, symptoms are gradually discovered and the patient seeks medical attention, accounting for about 77.86%.

　　2. Abdominal pain:Persistent dull pain or dull pain. It is more common in malignant tumors, accounting for 66.7%.

　　3. Weight loss:Anemia is more common in malignant tumors.

　　4. Ascites, cachexia:It is more common in late-stage malignant cases.

　　5. Intestinal obstruction: yesReported 21 cases of intestinal obstruction caused by primary mesenteric tumors, accounting for 30% of the primary lesions during the same period, which can occur in both the small and large intestines, and both benign and malignant tumors can cause intestinal obstruction. Among them, 5 cases of intestinal torsion, 4 cases of intussusception, 4 cases of intestinal wall compression, and 3 cases of intestinal wall infiltration.

　　6. Physical examination:A mass can be felt in the abdomen; benign tumors are mostly round, movable masses with clear boundaries and no tenderness; malignant tumors can be felt as active or fixed masses, often uneven, and hard.

　　Firstly, determine whether it is retroperitoneal tumor or mesenteric tumor, and then determine whether it is benign or malignant. It is also necessary to exclude whether it is mesenteric abscess, which often has fever, cystic mass, and is found to have septa in imaging examinations. Generally, retroperitoneal tumors are more fixed. Abdominal tumors can often move left and right or up and down, and develop slowly, are often multicystic, smooth, with clear boundaries, and have good general condition. Malignant tumors develop rapidly, grow quickly, have many systemic symptoms, fever, weight loss accompanied by abdominal pain, and anemia. In the late stage, there may be ascites, hard masses, unevenness, or fixation, mostly solid.

　　Specific preventive measures for primary mesenteric tumors include the following aspects:

　　1. Regular examinations

　　High-risk populations for primary mesenteric tumors, such as men over 40 years old, patients with familial multiple intestinal polyps, patients with ulcerative colitis, chronic schistosomiasis patients, and individuals with a family history of colorectal cancer, should undergo regular examinations.

　　2. Improve living habits

　　Pay attention to rest, avoid fatigue, maintain a good mental state, actively cooperate with doctors in treatment, and adhere to standardized medication, which is conducive to the treatment of the disease.

　　3. Prevent and treat intestinal diseases

　　Actively prevent various polyps, chronic enteritis (including ulcerative colitis), schistosomiasis, chronic dysentery, and other diseases. Early treatment is especially important for intestinal polyps. Colon polyps are divided into five categories, namely adenomatous polyps, inflammatory polyps, hamartomatous polyps, biochemical polyps, and mucosal hypertrophic exostoses, among which adenomatous polyps are true tumor polyps. In addition, it is necessary to actively treat habitual constipation and pay attention to maintaining smooth defecation.

　　The main clinical examination methods for primary mesenteric tumors are X-ray gastrointestinal barium meal examination, ultrasound, and CT scans, as follows:

　　1. X-ray gastrointestinal barium meal examination

　　They can show that the intestinal tract is compressed, deformed, narrowed, and displaced.

　　2. Ultrasound and CT scans

　　Ultrasound and CT scans can distinguish between retroperitoneal and intra-abdominal locations, cystic, cystic-solid, solid tumors, and can show the size of the mass, boundary conditions, and whether there are septa within the cystic ones.

　　Patients with primary mesenteric tumors should pay attention to strengthening nutrition in their diet, and can appropriately increase the intake of protein, such as lean meat, fish, dairy products, etc. In addition, attention should be paid to the intake of vitamins and trace elements to improve physical condition and enhance physical fitness. Change the habit of taking meat and high-protein foods as staple food. Eat less high-fat foods, especially controlling the intake of animal fats. Reasonably arrange daily diet, eat more fresh fruits and vegetables, which are rich in carbohydrates and rough fibers, and appropriately increase the proportion of coarse grains and mixed grains in staple food, and avoid being too fine and refined.

　　The principle of Western medicine treatment for primary mesenteric tumors should be surgery. For malignant lymphoma with radiotherapy or chemotherapy, chemotherapy or radiotherapy can be added after surgery.

　　Firstly, mesenteric cyst

　　Surgery can completely excise and resect the cyst without causing damage to mesenteric blood vessels, although most are benign, pathological examination should still be performed after surgery. Most people do not advocate for puncture aspiration or bag-shaped inversion surgery.

　　Secondly, mesenteric solid tumor

　　1. Benign tumor: surgical resection of the tumor. If the tumor invades mesenteric blood vessels, the tumor and vessels should be resected; if there is a blood supply obstruction in the intestinal tract, the intestinal tract should be resected to avoid recurrence of the tumor with a good prognosis.

　　2. Malignant tumor: radical resection of the tumor and regional lymph nodes, resection of the intestinal tract in those with invasion. For advanced tumors that cannot be cured, palliative resection should be performed.