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Journal of the Korean Surgical Society Aug 2012Intra-abdominal cystic masses originating from the retroperitoneum, mesentery or omentum are very rare and mostly benign tumors, but sometimes present as a complicated...
PURPOSE
Intra-abdominal cystic masses originating from the retroperitoneum, mesentery or omentum are very rare and mostly benign tumors, but sometimes present as a complicated cyst encasing the major organs.
METHODS
We analyzed the clinical findings, histologic diagnosis, and surgical outcomes in children who underwent operation for retroperitoneal, omental, and mesenteric cyst from 1998 to 2010, retrospectively.
RESULTS
Twenty-three patients (male, 12; female, 11) underwent the operation at a median age of 46 months (range, 9 days to 16 years). Among them, 17 cysts presented one or two symptoms such as abdominal mass, abdominal pain or abdominal distension. The median duration of symptoms was 7 days (range, 1 day to 365 days). Five were detected prenatally. Ten cysts were found in retroperitoneum, 8 in the omentum and 5 in the mesentery. The median diameter was 13 cm (range, 3 to 30 cm). Twenty cysts were completely removed. Five mesenteric cysts required bowel resection and anastomosis. Three of retroperitoneal cysts were impossible to complete excise because of location and extensiveness. Pathologically, 20 cysts were lymphangioma and 3 were pseudocyst. The morbidity was one of adhesive ileus and the mortality was one who had extensive retroperitoneal cyst with mesenteric cyst. He died from sepsis. During follow-up period, there was no recurrence.
CONCLUSION
Preoperative diagnosis and localization for these cysts are very difficult. Complete excision was possible in almost all cases despite the size, bringing a favorable outcome. The possibility of this disease entity should be considered as the cause of acute abdomen.
PubMed: 22880185
DOI: 10.4174/jkss.2012.83.2.102 -
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 -
European Journal of Case Reports in... 2020Mesenteric cysts are a rare nosologic entity, the diagnosis of which is complex due to their nonspecific presentation. They may emerge from any part of the mesentery and...
UNLABELLED
Mesenteric cysts are a rare nosologic entity, the diagnosis of which is complex due to their nonspecific presentation. They may emerge from any part of the mesentery and grow to any size, thus conditioning a wide range of clinical manifestations that renders them easily mistaken for different gastrointestinal pathologies. Diagnosis encompasses a mixture of clinical suspicion, imaging techniques and sometimes surgery, and curative treatment is based on complete surgical resection of the cyst. We hereby present a case of a mesenteric cyst that developed on the anterior abdominal wall of a 59-year-old man awaiting allogeneic bone marrow transplantation after being diagnosed with chronic myeloid leukaemia. He was admitted to the emergency room with complaints of an increased abdominal perimeter and increased weight, not associated with alterations to his dietary or physical exercise habits. Suspecting ascites in the context of leukaemic progression, the patient was admitted to the medical ward; however, subsequent study identified a mesenteric cyst as the most probable diagnosis and the patient was proposed to undergo surgery. He underwent laparotomic cyst excision without complications and the histological evaluation of the surgical specimen confirmed the diagnosis.
LEARNING POINTS
Although rare entities, mesenteric cysts should be suspected whenever nonspecific gastrointestinal symptoms are present and liquid collections are identified.Treatment consists of complete surgical excision, which, although not free of complications, is usually safe and the recurrence rate is very low.In light of the lymphatic theory with respect to the aetiology of mesenteric cysts, this nosologic entity should be highly suspected in oncologic patients where lymphangiogenesis is potentiated.
PubMed: 32309252
DOI: 10.12890/2020_001457 -
Cureus Nov 2022A mesenteric cyst is an uncommon ailment that can affect practically any abdominal quadrant in its presentation. They may turn up as an accidental discovery. Although...
A mesenteric cyst is an uncommon ailment that can affect practically any abdominal quadrant in its presentation. They may turn up as an accidental discovery. Although there are a number of hypotheses explaining the genesis of these cysts, the exact etiology is unknown. A 70-year-old female patient came to see us complaining of abdominal pain for a month and had trouble passing stools for 15 days. Contrast-enhanced computed tomography was done for the patient, which revealed a heterogeneously enhancing mass lesion in the abdominal cavity. The patient was then taken for an exploratory laparotomy procedure. To make the procedure thorough and easy, intraoperative partial drainage of the cyst fluid was carried out. We were able to observe the margins of the mesenteric cyst more easily as the partial drainage was carried out. The partial drainage decreased the volume and size of the mesenteric cyst, reducing the pressure effect on the surrounding structures and allowing easy mobilization of the intraabdominal structures during intraoperative examinations. The partial drainage of the cystic fluid also made the dissection process safer. After releasing all adhesions, the cyst was delivered outside and sent for histopathological analysis. The histopathological reports confirmed it to be a mesenteric cyst. The aim of this article is to educate the readers and to make fellow surgeons well aware of this condition. This will not only help fellow clinicians in better diagnosis and treatment but also help in the reduction of the overall burden of the healthcare society by reducing mortality and morbidity.
PubMed: 36600819
DOI: 10.7759/cureus.32015 -
Journal of Indian Association of... 2023Intestinal malrotation is a congenital anomaly resulting from abnormal or incomplete rotation and fixation of the midgut during embryogenesis. It commonly presents in... (Review)
Review
BACKGROUND
Intestinal malrotation is a congenital anomaly resulting from abnormal or incomplete rotation and fixation of the midgut during embryogenesis. It commonly presents in the neonatal period (75%) with sudden onset bilious vomiting and rarely beyond infancy (<10%).
AIM
The aim of the study was to highlight the clinical features, radiological findings, and treatment outcomes of patients with malrotation presenting beyond infancy.
MATERIALS AND METHODS
Eleven consecutive cases of delayed presentation of malrotation presented over a period of 5 years (2017-2021). Data were analyzed retrospectively.
RESULTS
Out of the 11 patients, four were female and seven were male. The age of patients ranged from 14 months to 18 years. Patients beyond infancy present usually with diffuse pain abdomen compared to neonates which present with sudden onset bilious vomiting and therefore difficult to diagnose. Five patients had associated abnormalities such as intussusception or nutcracker syndrome or mesenteric cyst or jejunal stricture or mesenteric lymphadenopathy along with malrotation. Patients underwent ultrasonography, upper gastrointestinal contrast study, and contrast-enhanced computed tomography abdomen to confirm the diagnosis. All patients underwent the Ladd procedure with four requiring resection anastomosis and one requiring excision of the mesenteric cyst. Eight out of eleven patients had favorable outcomes, two develop adhesive intestinal obstruction and required re-exploration, and one had persistent complaints of hematochezia.
CONCLUSION
Malrotation beyond infancy is a rare diagnosis. Malrotation in older children is usually not suspected because of the wide range of symptoms. A high index of suspicion on ultrasound or computed tomography is required to demonstrate the reversal of superior mesenteric artery and superior mesenteric vein position and related conditions. Early intervention and treatment can prevent catastrophic events such as intestinal volvulus and intestinal ischemia in these patients.
PubMed: 37635889
DOI: 10.4103/jiaps.jiaps_2_23 -
Case Reports in Surgery 2020Hydatid disease (HD) is caused by Echinococcus granulosus and is endemic in many parts of the world. This parasitic tapeworm can produce cysts in almost every organ of...
Hydatid disease (HD) is caused by Echinococcus granulosus and is endemic in many parts of the world. This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. The spleen and mesentery are unusual locations. We report a case of simultaneous huge splenic and mesenteric hydatid cyst in a 91-year-old male patient. The patient was presented with chronic abdominal pain, increased frequency of defecation, and typical history of animal contact (cattle, sheep, and dogs). After performing imaging studies, he was diagnosed with a simultaneous huge spleen and pelvic mesentery hydatid cyst that was managed surgically by splenectomy, pelvic mesenteric cyst deroofing, and partial cystectomy.
PubMed: 32082688
DOI: 10.1155/2020/7050174 -
International Journal of Surgery Case... 2014Cysts of the mesentery are among surgical rarities. The clinical presentation is not characteristic and in addition, the preoperative imaging although suggestive is not...
INTRODUCTION
Cysts of the mesentery are among surgical rarities. The clinical presentation is not characteristic and in addition, the preoperative imaging although suggestive is not diagnostic in this case ultrasound and CTscan was consistent with giant mesenteric cyst. In most cases, the diagnosis is confirmed after surgical exploration.
PRESENTATION OF CASE
A 42 yrs old male patient on exploratory laparotomy had a 14cm×10cm×10 cm cysts which was seen arising from the mesentery ofdistal jejunum 80cm from the duodeno jejunal flexure. The cyst was enucleated successfully from themesentery without entailing resection. The cyst contained milky white fluid consistent with a chylolymphatic cyst. The diagnosis was confirmed on histopathology which revealed a cyst wall with lymphoidaggregates. After 3 years of follow-up, the patient is doing well and there is no evidence of recurrence.
DISCUSSION
The cysts may be asymptomatic or maymanifest with abdominal pain, distension lump or intestinal obstruction. Our patient was symptomatic with mild and long standing abdominal pain. The definitive diagnosis of these lesions is difficult prior to surgical exploration as there are no pathognomonic symptoms or characteristic imaging findings.
CONCLUSION
Cysts of the mesentery are among surgical rarities. In most of the cases the diagnosis is confirmed after surgical exploration and removal of thecyst. We would like to emphasize the importance of successful enucleation of the cyst irrespective of its size due to its independent blood supply as opposed to enterogenous cyst which requires bowel resection and anastomosis.
PubMed: 24976602
DOI: 10.1016/j.ijscr.2014.05.008 -
Clinics and Practice Sep 2011Mesenteric cysts are uncommon benign abdominal lesions with no classical clinical features. The preoperative diagnosis requires the common imaging modalities but the...
Mesenteric cysts are uncommon benign abdominal lesions with no classical clinical features. The preoperative diagnosis requires the common imaging modalities but the final diagnosis is established only during surgery or histological analysis. The treatment of choice is complete surgical excision. We report an 18-year-old female with a non-specific abdominal pain and discomfort since 3 weeks. Her CT scan showed a huge cystic swelling, which necessitated surgical exploration. Preoperatively, a giant cyst was encountered with displacement of bowel loops. The cyst was completely removed and histology report confirmed mesenteric cyst without evidence of malignancy.
PubMed: 24765349
DOI: 10.4081/cp.2011.e108 -
African Journal of Paediatric Surgery :... 2022Mesenteric cysts are rare intra-abdominal masses and high index of suspicion is required to clinically suspect this pathology and make a definitive diagnosis. They are...
BACKGROUND
Mesenteric cysts are rare intra-abdominal masses and high index of suspicion is required to clinically suspect this pathology and make a definitive diagnosis. They are most commonly located in the ileal mesentery but can be located anywhere along the gastrointestinal tract mesentery and may extend into the retroperitoneum. The rarity of these anomalies and diversity of clinical picture pose challenges in the diagnosis and operative management. The objective of this study is to determine the demographic pattern, clinicopathological diagnosis and management outcome of mesenteric cysts in our hospital.
MATERIALS AND METHODS
This retrospective study was conducted on children operated for mesenteric cysts from October 2013 to September 2020. Statistical analysis was performed using Open Epi Version 3.01.
RESULTS
Out of 32 children with a diagnosis of mesenteric cyst, 78% were below 5 years of age. Small intestine was affected in 26 cases and large bowel mesentery was the site of origin in six cases. Complete excision of mesenteric cyst was possible in all cases. Bowel resection was required in ten cases (31%) to enable complete excision. Bowel resection was required more often in children operated on emergency than those with elective surgery, and is statistically significant (P = 0.04; confidence interval: 0.05-0.96, odds ratio: 0.23). An uncommon co-existence with ileal atresia and detection of rare chylolymphatic cyst in another infant were also remarkable findings. Histopathology proved the diagnosis in all cases. There was no mortality or recurrence during hospitalisation and follow-up, which ranged from 3 months to 3 years.
CONCLUSIONS
Mesenteric cysts present with diverse clinical features and children below 5 years of age are most commonly affected. Complete surgical excision is the optimal treatment and may require bowel resection in significant number of cases, especially those operated during emergency. Histopathology is the gold standard for diagnosis.
Topics: Abdomen; Child; Cysts; Humans; Infant; Mesenteric Cyst; Mesentery; Retrospective Studies
PubMed: 34916349
DOI: 10.4103/ajps.AJPS_158_20 -
Case Reports in Surgery 2022Paratubal cysts are adnexal masses located in the broad ligament; whenever the size of the cyst is >20 cm, it is considered a giant cyst and can present with...
Paratubal cysts are adnexal masses located in the broad ligament; whenever the size of the cyst is >20 cm, it is considered a giant cyst and can present with complications including ovarian torsion and perforation. Diagnosis can be made clinically with the help of radiological investigations, although the gold standard diagnostic tool is diagnostic laparoscopy. Managing this condition relies mainly on surgical intervention (open or laparoscopic). Giant paratubal cysts carry challenges in their surgical excision as they carry a higher risk of spillage. We present a case of giant paratubal cyst in a 26-year-old Bahraini female who presented with abdominal distension and pain for 3 years.
PubMed: 36245686
DOI: 10.1155/2022/4909614