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We expose a mesenteric cyst with obstruction on the left ureter. Physical abdominal examination was essential in the mass diagnosis. Definitive location, size and liquid structure was confirmed by CT.
We report on a 10-year old boy suffering from chronic abdominal pain. Clinical examination and imaging modalities revealed that the patient had mesenteric cysts. Exploratory laparotomy revealed two mesenteric cysts of various size and multiple enlarged mesenteric lymph nodes. M. tuberculosis was identified and histology of the specimens proved the existence of abdominal tuberculosis.
Although intra-abdominal lymphangioma and mesenteric cysts are rare benign tumours, they have to be considered in the differential diagnosis of abdominal pain. Differentiation of these lesions is important, because lymphangiomas may follow a proliferative and invasive course. From 1979 to 1993 four patients with intra-abdominal cystic lymphangiomas and two with mesenteric cysts underwent operations in our surgical department. Five of these six patients had abdominal symptoms, ranging from unspecific abdominal pain to acute clinical abdomen. In all cases surgical enucleation or resection and histological classification were necessary before final diagnosis was possible.
Intestinal obstruction secondary to a mesenteric cyst in childhood, although rare, should be considered in the child between ages 2-10 years with chronic or acute obstruction. A case of mesenteric cyst associated with obstruction is presented, along with a review of the literature.
BACKGROUND: Symptomatic mesenteric cysts account for only 1 in 100,000 acute adult and 1 in 20,000 acute paediatric admissions. Acute symptoms are related to compression of intra-abdominal organs or stretching of the mesentery by rapid expansion. An abdominal mass, mobile in transverse but not longitudinal plane, is often the only physical finding. METHOD: We outline the presentation, management and histological findings of 6 cases that presented to this hospital from 1987-1997. RESULTS: There were 5 adults aged 32-79 yr and an 8 yr old boy. The child presented acutely with a painful tender abdominal mass. Of the adults, 1 presented acutely, 2 with chronic symptoms and 2 were incidental findings. Mesenteric cysts were successfully resected in all cases. CONCLUSION: Surgical intervention is recommended and resection of adjacent bowel may be necessary for complete excision. Successful minimal access surgery via the laparoscope has been reported and may become more widely applicable.
The incidence of mesenteric cysts is relatively uncommon. Sprague" examined its frequency and noted that five large hospitals located in the LosnAngeles area averaged one documented case of mesenteric cyst per 100,000 hospital admissions. The most common location appears to be the mesentery of the small bowel, especially that of the ileum. Cysts of the mesentery of the large bowel are somewhat less fre- quent, accounting for approximately 38% of the total incidence. Those involving the large bowel most commonly involve the mesentery of the sigmoid colon.
A case of a mesenteric cyst presenting as the sudden onset of bloody ascites is reported. The diagnosis was suggested by abdominal ultrasonography.
Personal experience based on a clinical case of a young woman with acute abdominal pain referable to acute appendicitis is presented. The surgical procedure was performed through a Mc Burney incision and revealed the rupture of mesenteric cysts; removal of the cysts was carried out without intestinal resection. Post-operative course was uneventful and 2 years follow-up showed no recurrence. Mesenteric cysts are an uncommon pathology, mainly in adult ages. After an analysis of the incidence and etiology, the pathological features and types of clinical presentation are discussed. Diagnosis in asymptomatic cases is usually made in search of other diseases. Complications are rare: rupture, infection and intestinal obstruction. In such cases, the clinical presentation is usually attributable to the main causes of acute abdomen, unless ultrasonography or CT scan are performed. When mesenteric cyst is diagnosed, a laparoscopic approach should be performed, even if in emergency traditional surgery is justified. Total excision of the cyst is necessary to avoid recurrence and obtain a correct pathologic evaluation.
The Authors report a case of chylous mesenteric cyst of great size in an adult patient. They stress the diagnostic value of roentgen and sonographic findings that are determinant for a correct preoperative diagnosis. Sonography is the most important diagnostic tool; it leads to identification and localization of the mass; moreover it gives other important information about its physic composition. The various pathology that have a similar sonographic relief are discussed and differential diagnostic characters are referred.
A five-year old girl who presented with an acute abdominal emergency was found to have a haemorrhagic mesenteric cyst intraoperatively. The clinical picture and the mode of management are presented and discussed. The possibility of a complicated mesenteric cyst should be considered in the differential diagnosis in patients with an acute abdomen.
In the light of three cases of their own observation, of children with mesenteric cysts causing complete or incomplete intestinal obstruction, the authors review the existing literature on the subject, discuss the etiology, clinical aspects, and therapeutic methods for the correction of such pathology, and conclude by calling attention to mesenteric cysts as possible causes of intestinal transit disorders in the pediatric age group.
Two cases of mesenteric cysts are reported. Realtime ultrasound demonstrated the typical appearance of well-defined, anechoic masses. In addition, a solid appearance with a honeycomb pattern of internal echos was observed in one case. The other case had the appearance of loculated, septated ascites. Ultrasound and CT correlation are discussed.
Although extra-intestinal non-typhoidal Salmonella infections are common in developing countries, infection of the mesenteric cyst with Salmonella enteritidis is an extremely rare occurrence. Review of the English literature has revealed one report up to this date. The case of a 4-year-old boy with a mesenteric cyst infected with Salmonella enteritidis is presented.
The authors describe five cases of mesenteric cysts evaluated by ultrasonography and computed tomography: 3 cases of cystic lymphangioma, 1 vestigial serous cyst, 1 dermoid cyst. Ultrasonography is useful for analyzing the contents of these lesions, and must be utilized to search for possible pelvic anomalies, allowing diagnosis of pendunculated ovarian cysts for example. CT offers better sensitivity for evaluating the effect of such cysts on neighboring viscera and particularly on the intestine. CT is also better for identification of the fatty components indicative of dermoid or chylous cysts. These rare tumors are almost always benign, and a combined modality imaging approach based on ultrasound and CT suffices for diagnosis.
The acute abdomen in a newborn is not an uncommon condition and the causes are multiple; however, intestinal occlusion with gangrene of the bowel due to a mesenteric cyst has not been recorded before and the purpose of this paper is to record a case of a newborn with intestinal obstruction and gangrene of the bowel due to a mesenteric cyst.
Of 11 infants and children with mesenteric cysts, seven patients were boys and four, girls. Clinical findings included abdominal distention, pain and vomiting in seven patients, while a movable abdominal mass was noted in four. Two patients presented with peritonitis and one patient, in a state of shock. All patients underwent laparotomy-seven as an emergency procedure. Volvulus with perforation and infarction was noted in the two patients uith peritonitis. Excision of the cyst required resection of the small intestine and end-to-end anastomosis in seven patients, while simple enucleation was possible in four. All 11 patients survived, and there have been neither subsequent complications nor recurrences. Early recognition and appropriate resection of these benign, but occasionally life-threatening, malformations is associated with an excellent long term prognosis.
The authors report a case of an unusual abdominal tumor-mesenteric cyst. When it is found active surgical approach is recommended. Laparoscopic resection of the cyst is considered as the method of choice.
The authors reports a case of a young woman suffering from mesenteric cyst. The incidence of these lesions is 1 to 100,000 admissions in adult patients and 1 to 20,000 admissions in pediatric age. These cysts, with retroperitoneal and omental cysts, have a similar etiopathogenesis as lymphatic ectopic tissue. In the majority of cases these cysts are asymptomatic and often the diagnosis is intraoperative. In this case the cyst was removed successfully with laparoscopic approach. This mini-invasive method allows a complete and radical excision of the cyst and reduces postoperative hospital stay and morbidity.