Juxta-intestinal mesenteric nodes

At a glance

English

Juxta-intestinal mesenteric nodes

Latin (TA2)

Nodi juxtaintestinales

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the juxta-intestinal mesenteric nodes

The superior mesenteric nodes lie in the mesentery of the small intestine, a broad fan of peritoneum that holds the jejunum and ileum to the posterior abdominal wall. They are arranged in tiers from the gut wall back to the root of the mesentery. The juxta-intestinal nodes form the outermost tier, lying closest to the bowel itself.

These nodes sit among the short straight arteries (vasa recta) that leave the last arterial arcades to enter the intestinal wall. They are small and numerous, set a centimetre or two from the border where the mesentery joins the bowel. Further in lie the intermediate nodes along the arcades and jejunal and ileal arteries, and then the central nodes around the trunk of the superior mesenteric artery.

Lymph reaching them comes from the wall of the jejunum and ileum. During digestion this lymph is milky with absorbed fat, collected by the lacteals of the villi, and so it is called chyle. From the juxta-intestinal tier it passes inward through the intermediate and central nodes, then into the intestinal trunk and the cisterna chyli.

These are the first nodes to receive any material that crosses the lining of the small intestine. In children they often swell during viral infections, giving abdominal pain that can mimic appendicitis. They may also hold early spread from tumours of the small bowel, and when a segment of bowel is resected for cancer, the wedge of mesentery taken with it includes these nodes.

Course and drainage

Begins at

Afferent vessels and lacteals from the wall of the jejunum and ileum.

Drains into

Efferent vessels pass inward to the intermediate and then central superior mesenteric nodes, and on to the intestinal trunk.

Drains

First filter for lymph and absorbed fat from the small intestine. They swell in mesenteric adenitis and may hold early spread of small-bowel tumours, so they are taken with the mesentery at resection.