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Journal of Surgical Case Reports May 2023Mesenteric cysts are uncommon intra-abdominal lesions that account for only one in every 100 000 adult hospitalizations. Their diagnosis is based on a comprehensive...
Mesenteric cysts are uncommon intra-abdominal lesions that account for only one in every 100 000 adult hospitalizations. Their diagnosis is based on a comprehensive clinical examination as well as radiological modalities such as ultrasonography and computed tomography (CT) scans, and it is usually a clinical challenge because of non-specific symptoms. We present our first case of a 51-year-old man with a simple mesenteric cyst accompanying acute appendicitis diagnosed by CT scan of the abdomen and treated by exploratory laparotomy, complete enucleation of the cyst and appendectomy with a 10 month follow-up without complications or recurrence. This type of presentation has not been thoroughly investigated, with only two children reported during our literature review. Even if there is a high level of suspicion, a CT scan is required for confirmation.
PubMed: 37220593
DOI: 10.1093/jscr/rjad275 -
JPGN Reports Feb 2023Chylolymphatic cyst, variant of mesenteric cyst, is a rare entity. Clinical presentation and radiological features are not characteristic, so diagnosis can be made...
Chylolymphatic cyst, variant of mesenteric cyst, is a rare entity. Clinical presentation and radiological features are not characteristic, so diagnosis can be made finally on histopathology. We report an extremely rare case of giant chylolymphatic cyst measuring >15 cm. A 2-year-old female presented with abdominal pain and vomiting. On examination, a ill-defined and firm mass was palpable just below umbilicus. Positron emission tomography-computed tomography scan revealed a large ill-defined lesion, which measured 16 × 13.2 × 6.7 cm in size and was seen in relation to the abdominal mesentery. Provisional diagnosis of mesenteric cyst was made. Laparotomy revealed multiple lymphatic cysts of variable size arising from the mesentery of proximal ileum. Histopathology examination confirmed the presence of a giant chylolymphatic cyst. Chylolymphatic cysts are rare entity and should be kept in mind while diagnosing a pediatric case of abdominal cysts.
PubMed: 37181923
DOI: 10.1097/PG9.0000000000000274 -
International Journal of Surgery Case... May 2023• A mesenteric hydatid cyst is very uncommon. • A mesenteric hydatid cyst can mimic as any peritoneal cystic masses. • Vague symptoms can also present as cystic...
• A mesenteric hydatid cyst is very uncommon. • A mesenteric hydatid cyst can mimic as any peritoneal cystic masses. • Vague symptoms can also present as cystic lesion. • Surgery is helpful in relieving mass effect and spillage of the fluid to prevent anaphylaxis.
PubMed: 37105028
DOI: 10.1016/j.ijscr.2023.108260 -
International Journal of Surgery Case... May 2023Mesenteric cysts are uncommon intra-abdominal benign masses that appear in childhood with varying degrees of clinical manifestations, ranging from being asymptomatic to...
INTRODUCTION AND IMPORTANCE
Mesenteric cysts are uncommon intra-abdominal benign masses that appear in childhood with varying degrees of clinical manifestations, ranging from being asymptomatic to presenting as an acute abdomen. The diagnosis is made incidentally during the work-up for other abdominal pathologies such as acute appendicitis, bowel obstruction, etc. The treatment is mostly surgical and varies depending on the clinical type of the lesion.
CASE PRESENTATION
A 26-month-old child was referred to our teaching hospital's pediatric surgery department with an abdominal mass. The patient had previously complained of constipation and been treated symptomatically with laxatives. Ultrasonography reported ovarian cysts confirmed by computerized tomography scanning (as a misdiagnosis report of an ovarian cyst instead of a mesenteric cyst), done outside the hospital in a private diagnostic center.
CLINICAL DISCUSSION
The patient was prepared for operation and during the surgical procedure, she was found to have a duplex cyst, which was mostly incorporated in the mesentery of the distal 1/3 of the transverse mesocolon. The cyst was enucleated through a lower midline laparotomy incision without bowel resection and anastomosis. The histopathological analysis of the specimen confirmed a mesenteric cyst.
CONCLUSION
Mesenteric cysts are rare lesions in children and should be considered when approaching any intra-abdominal mass. Except for the rare cases where intestinal resection and/or partial cyst excision are required, all mesenteric cysts can be excised while preserving intestinal integrity and vascular supply.
PubMed: 37068457
DOI: 10.1016/j.ijscr.2023.108216 -
International Journal of Surgery Case... Apr 2023Mesenteric cystic lymphangioma (MCL) is a rare benign intraperitoneal mass with congenital origin, and it is extremely rare in adults. Mesentery is an unusual location...
INTRODUCTION AND IMPORTANCE
Mesenteric cystic lymphangioma (MCL) is a rare benign intraperitoneal mass with congenital origin, and it is extremely rare in adults. Mesentery is an unusual location for cystic lymphangioma too. Clinical presentations are nonspecific, and diagnosis is challenging. It can mimic other surgical complications like appendicitis or any acute abdomen causes, so the review of cases is necessary for the best management and surgical planning.
CASE PRESENTATION
We have presented a 22-year-old man presented with complaints of abdominal pain, nausea and vomiting. In laparotomy, a cyst was found with large size around the small intestine which caused mesenteric ischemia and changed the color of the small bowel to an ischemic view. The resected cyst was sent and confirmed by the pathology as lymphangiomatosis. MCL is a rare cause of obstruction, which was found accidentally in this case.
CLINICAL DISCUSSION
MCLs are clinically challenging lesions with unspecific broad spectrum of clinical presentation ranges. We discuss a rare finding in an adult with intestinal volvulus and mesenteric ischemia. Medical literature and reviews have been searched to find more relevant information about MCLs for the better optimal planning in surgery.
CONCLUSION
MCL is a challenging and infrequent case of surgery. Most of the time, it does not cause any complications, but it can also cause some life-threatening conditions like mesenteric ischemia or volvulus and lead to emergent surgery. Complete tumor removal is optimal for managing intra-abdominal cystic lymphangioma with the slightest chance of recurrence.
PubMed: 37004456
DOI: 10.1016/j.ijscr.2023.108083 -
African Journal of Paediatric Surgery :... 2023Acute abdominal pain is a common complaint in children. We came across several unusual causes of acute abdomen including jejunal haematoma, perforation and abdominal...
Acute abdominal pain is a common complaint in children. We came across several unusual causes of acute abdomen including jejunal haematoma, perforation and abdominal abscess following hydrostatic intussusception reduction, twisting of mesenteric cyst, perforation of sigmoid colon and Meckel's diverticulum presenting with intussusception. In this article, we aim to present imaging features of these entities so that paediatric surgeons, radiologists and other health-care providers are aware of these unusual manifestations of acute abdomen.
Topics: Humans; Adolescent; Child; Abdomen, Acute; Intussusception; Abdominal Pain; Meckel Diverticulum
PubMed: 36960512
DOI: 10.4103/ajps.ajps_161_21 -
Surgical Treatment of Mesenteric Lymphatic Malformations in Children: An Observational Cohort study.Journal of Pediatric Surgery Sep 2023Few studies have analyzed the cyst characteristics and complications of mesenteric lymphatic malformations (ML). This study aimed to compare ML's cyst characteristics... (Observational Study)
Observational Study
BACKGROUND
Few studies have analyzed the cyst characteristics and complications of mesenteric lymphatic malformations (ML). This study aimed to compare ML's cyst characteristics and preoperative complications at different locations and suggest a modified ML classification for patients requiring surgery.
METHODS
In total, 157 ML patients underwent surgery at Beijing Children's Hospital between January 2010 and December 2021. The cyst characteristics and preoperative complications were reviewed. The surgical methods for ML were analyzed according to the modified ML classification (Type I, n = 87, involving the intestinal wall; Type II, n = 45, located in the mesenteric boundaries; Type III, n = 16, involving the root of the mesentery; Type IV, n = 7, multicentric ML; Type V, n = 2, involving the upper rectum).
RESULTS
Overall, 111 (70.7%) ML were located at the intestinal mesentery and 44 (28.0%) at the mesocolon. Type I and type II ML mainly involved intestinal mesentery (64.9%) and mesocolon (56.8%), respectively (P < 0.001). Microcystic-type ML and ML with chylous fluid were only located in the intestinal mesentery. Intestinal volvulus was only found in patients with ML in the intestinal mesentery (P < 0.001), whereas ML in the mesocolon were more prone to hemorrhage (P = 0.002) and infection (P = 0.005). ML in the jejunal mesentery was an independent risk factor for intestinal volvulus (OR = 3.5, 95% CI 1.5-8.3, P = 0.003). The surgical methods significantly differed between Type I and type II ML (P < 0.001).
CONCLUSIONS
ML at different locations have different characteristics. For patients requiring surgery, the new ML classification can be used to select an appropriate surgical method.
LEVEL OF EVIDENCE
Level III.
Topics: Humans; Child; Intestinal Volvulus; Mesentery; Lymphatic Vessels; Lymphatic Abnormalities; Cohort Studies; Cysts; Mesenteric Cyst
PubMed: 36931944
DOI: 10.1016/j.jpedsurg.2023.02.041 -
The American Surgeon Aug 2023We describe the case of a 32-year-old female who presented to the emergency department (ED) with a 3-day history of severe epigastric abdominal pain accompanied by...
We describe the case of a 32-year-old female who presented to the emergency department (ED) with a 3-day history of severe epigastric abdominal pain accompanied by nausea, vomiting, and constipation. Past medical history was significant for known right hydrosalpinx and previous pelvic inflammatory disease (PID), without past surgical history. Clinical examination revealed a hemodynamically stable patient with a soft but distended abdomen, tenderness in the epigastric region, without signs of peritonitis. Bloodwork including white blood cell count, electrolytes, and lactic acid was unremarkable. Initial computed tomography (CT) scan of the abdomen and pelvis with contrast demonstrated a small bowel obstruction (SBO) with a transition point in the right lower quadrant, accompanied by mesenteric edema and free fluid. Exploratory laparotomy was performed and revealed obstruction secondary to dense adhesions involving the terminal ileum, appendix, sigmoid colon, and right ovary. Lysis of adhesions, appendectomy, and excision of a right paratubal cyst were performed. Histopathology demonstrated endometriosis of the appendix and a benign paratubal cyst.
Topics: Female; Humans; Adult; Endometriosis; Parovarian Cyst; Intestinal Obstruction; Intestine, Small; Ileum; Tissue Adhesions
PubMed: 36916006
DOI: 10.1177/00031348231161705 -
Cureus Jan 2023Mesenteric and omental cysts can be seen at any age, with one in three cases seen in patients under 15 years old. These cysts represent one in 20,000 pediatric...
Mesenteric and omental cysts can be seen at any age, with one in three cases seen in patients under 15 years old. These cysts represent one in 20,000 pediatric admissions. Here we share the case of a five-year-old female patient at a health center in a developing country, with the purpose of contributing to documentation in the region.
PubMed: 36874707
DOI: 10.7759/cureus.34443 -
Cureus Jan 2023Mesenteric cysts are rare benign abdominal lesions that possess the risk of malignant transformation in 3% of reported cases. Most cysts are asymptomatic and diagnosed...
Mesenteric cysts are rare benign abdominal lesions that possess the risk of malignant transformation in 3% of reported cases. Most cysts are asymptomatic and diagnosed incidentally or during the management of their complications. In the majority of cases, they arise from the mesentery of the small bowel, followed by the mesocolon. We present a case report of a 20-year-old female with an abdominal mesenteric cyst.
PubMed: 36865967
DOI: 10.7759/cureus.34325