[Mesenteric cyst. Mesenteric cyst as the cause of an abdominal tumor].
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Mesenteric cyst.
Mesenteric cyst is one of the rarest abdominal tumours, with approximately 820 cases reported since 1507. The incidence varies from 1 per 100,000 to 250,000 admissions. The lack of characteristic clinical features and radiological signs may present great diagnostic difficulties. The cyst may present in one of three ways: (i) non-specific abdominal features; (ii) an incidental finding; or (iii) an acute abdomen. Abdominal pain is the major presenting symptom. Abdominal mass is found in more than 50% of cases and 40% of cases are discovered incidentally. More than one aetiological mechanism is probably involved in the development of mesenteric cysts. Mesenteric cysts have been reported from the duodenum to the rectal mesentery but are most commonly located in the ileal mesentery. Malignant cysts occur in less than 3% of cases. Enucleation of the cyst is the treatment of choice. Knowledge of these tumours is important due to the various complications associated with suboptimal surgical management. Two cases of mesenteric cysts are presented including a recurrent mesenteric cyst in a post-partum woman demonstrating the inferior technique of internal marsupialization. The association of mesenteric cyst with pregnancy is discussed.
Abdomen, Acute↗
Retroperitoneoscopic excision of a mesenteric cyst.
Mesenteric cysts are rare intra-abdominal lesions. We present a case of a mesenteric cyst that was discovered by abdominal computed tomography (CT) and excised by retroperitoneoscopic surgery. There have been 10 reports of excision of mesenteric cysts by laparoscopy in the literature, but retroperitoneoscopic resection of such cysts has not been reported. This case suggests that when a mesenteric cyst arises from the ascending or descending colon, the retroperitoneal approach has a lower risk of traumatizing the bowel than does the laparoscopic intra-abdominal approach, and it does not have to compress other intra-abdominal organs.
Adult↗
Mesenteric cysts.
Mesenteric cysts continue to be of special interest because of their diverse presentation and the lack of definitive diagnostic tests. Nine patients with mesenteric cysts were treated at St. Agnes Hospital between 1973 and 1984. The most common location was in small bowel mesentery (67%) followed by the mesocolon (33%). The mesenteric cysts were incidental findings in four of the nine patients (45%). Enucleation was the treatment of choice in eight patients (88%), followed by right hemicolectomy in one patient. Two patients had complications, one wound infection and one urinary tract infection. Simple enucleation has proven to be adequate treatment in most instances. Large bowel resection may be necessary when mesenteric cysts are located in the mesocolon and enucleation is not feasible without compromising the blood supply to the adjacent bowel.
Adolescent↗
Laparoscopic treatment of mesenteric cysts.
Mesenteric cysts are rare intraabdominal tumors. We review the diagnosis, laparoscopic management, patient's outcome and follow-up of evaluation for three cases of mesenteric cyst that presented to Istanbul University, Istanbul Medical School, Department of Surgery, from 1999 to 2002. All of the patients presented with nonspecific abdominal symptoms such as constipation, abdominal discomfort, and anorexia. Preoperative evaluation for differentiating mesenteric cyst from malignancy is made by abdominal ultrasound and computed tomography. The procedure was completed laparoscopically using three trocars in three patients. In one patient retroperitoneal resection was performed. There were no intraoperative or postoperative complications. The follow-up periods ranged from 6 to 36 months, and there were no recurrences. Currently, the surgical treatment of mesenteric cyst should be performed by laparoscopy, which offers significant advantages in terms of reduced morbidity and hospital stay. For appropriate cases in which cyst arises from mesenterium of colon, the retroperitoneal approach should be applied.
Adult↗
Acute abdomen caused by a ruptured spontaneously infected mesenteric cyst.
Mesenteric cysts are uncommon and usually asymptomatic abdominal tumors. Spontaneous infection is a very rare complication of these lesions. This report presents a case of spontaneously infected and perforated mesenteric cyst. Any incidental mesenteric cyst diagnosed during radiological examination should be removed completely, even if it has been asymptomatic, to prevent potential life-threatening complications.
Abdomen, Acute↗
Role of laparoscopic surgery in treatment of mesenteric cysts.
Mesenteric cysts are rare benign intraabdominal lesions without typical clinical findings. Treatment is indicated if they become symptomatic due to enlargement of the cyst. We report 3 patients who were treated by laparoscopic surgery. In 3 patients (3 women, ages 18, 18, 46 years) admitted to our hospital with uncharacteristic abdominal pain, a mesenteric cyst 4.5-18 cm in diameter was diagnosed by ultrasonography and CT scan or MRI. One cyst was partially resected laparoscopically by unroofing of the surface, and the other two were resected completely. There were no intra- or postoperative complications. During follow-up, cyst recurrence was diagnosed in the patient with cyst unroofing 10 months after surgery, and complete cyst resection was successfully performed laparoscopically. Mesenteric cysts can be successfully managed laparoscopically. In order to prevent recurrence, complete resection should be performed.
Adolescent↗
Laparoscopic excision of a mesenteric cyst diagnosed preoperatively as an ovarian cyst.
Mesenteric cysts are uncommon benign, abdominal tumors usually managed by general surgeons. We encountered an unusual mesenteric cyst that was diagnosed preoperatively as an ovarian cyst. It was located in the pelvic cavity inside the mesoappendix. We excised the cyst and adjacent vermiform appendix by laparoscopy. Histopathologic examination revealed mucinous cystadenoma. To the best of our knowledge, this is the first reported case of a mesenteric cyst removed by a gynecologic laparoscopist.
Adult↗
Intestinal obstruction due to a mesenteric cyst.
Mesenteric cysts are rarely thought of, may be difficult to diagnose, and are usually asymptomatic except when complicated. Intestinal obstruction is a rarely reported complication of these cysts. A case of mesenteric cyst that was causing obstruction of the large bowel is presented, along with a review of the literature.
Aged↗
Laparoscopic resection of a mesenteric cyst.
Mesenteric cysts are rare intra-abdominal tumors with an incidence around one case per 100,000 hospital admissions. The clinical presentation is variable; patients may be asymptomatic or present with either acute or chronic abdominal pain. Physical examination commonly demonstrates a smooth, round and mobile abdominal mass. Differential diagnosis includes any abdominal cyst or tumor. Laboratory tests are usually helpless. Ultrasonography and CT scans are the best diagnostic tools. The treatment of choice is the total resection of the cyst, which is regularly performed by open surgery. This paper reports a case of a mesenteric cyst successfully resected by laparoscopy, and addresses the possible uses of this approach.
Adult↗
[Mesenteric cyst].
Mesenteric cysts are rare abdominal tumors. Their incidence varies in different papers from one in 27,000 to one in 250,000 hospital admissions. Five patients with mesenteric cysts were treated at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo between November 1982 and October 1992. The most common location was in the small bowel (60%). All of them were treated by surgery. One case was found incidentally. Treatment of choice is enucleation. It was realized in two cases (40%). The others had segmental bowel resection.
Abdominal Pain↗
Laparoscopic management of mesenteric cyst.
Mesenteric cysts are rare intra-abdominal tumors. Most are found during laparotomy for other reasons. The symptoms are often vague and minimal. CT of the abdomen gives the most information and is the diagnostic method of choice. The preferred treatment for mesenteric cysts is complete resection at laparotomy. However, the advancement of minimal-access surgery has allowed laparoscopic excision as a safe and advantageous approach with minimal morbidity and shorter hospital stay and recovery time for the patient.
Adult↗
A novel technique for the laparoscopic resection of mesenteric cysts.
Mesenteric cysts are rare, invariably benign intraabdominal tumors. Optimal surgical management requires complete excision of these lesions. The advent of laparoscopic surgery has allowed resection of these cysts to be achieved without full laparotomy. However, laparoscopic resection necessitates drainage of the cyst within the abdomen to facilitate extraction of the cyst through the laparoscopic ports. This article describes a novel technique in which the cyst was partially aspirated as the initial surgical maneuver. This in turn allowed traction to be applied to the cyst wall, such that it could be drawn up into the epigastric port, to aid the further dissection and removal of the cyst from the peritoneal cavity.
Dissection↗
[Large mesenteric cyst in a patient suspected of ovarian cyst].
Mesenteric cystic tumors are very rare. They may simulate the ovarian cysts. We report a case of a 38 year-old woman with large cystic tumor suggesting ovarian cyst. The patient was operated on and we found that genital organs were normal. Besides there was a large cyst of small intestine mesentery with 10 liters of clear fluid. The cyst was removed. Histological material showed mucinous cystadenoma.
Adult↗
[Mesenteric cysts].
INTRODUCTION: Mesenteric cysts and cystic mesenteric tumors are very rare abdominal growths. They may be localized all over the mesentery, from duodenum to rectum, however, they are mostly found in the ileum and right colon mesentery. There are several classifications of these formations, among which the one based on histopathologic features including 6 groups has been most commonly used: 1) cysts of lymphatic origin--lymphatic (hilar cysts) and lymphangiomas; 2) cysts of mesothelial origin--benign or malignant mesothelial cysts; 3) enteric cysts; 4) cysts of urogenital origin; 5) dermoid cysts; and 6) pseudocysts--infectious or traumatic etiology. PATIENTS AND METHODS: Two adult female patients treated at the Department of Surgery, Zabok General Hospital, are presented. The diagnosis of mesenteric cyst was based on explorative laparotomy indicated for a cystic abdominal growth and characteristic palpatory finding, US and CT findings. In both patients, the cysts were successfully treated by total cystectomy. Pathohistologic findings pointed to lymphatic cysts. Control US finding at 3 months postoperatively was normal in both patients. DISCUSSION: Cystic lymphangioma mostly occurs in the first decade of life, with a female predominance. It is usually accompanied by acute abdominal symptomatology. Lymphatic cysts occur later in life (1:100,000 in adults and 1:20,000 in children), also show female predominance, and as a rule are asymptomatic. A mesenteric cyst, especially lymphatic, should be suspected in the presence of painless abdominal tumor, with occasionally painful abdominal pressure, normal laboratory findings, and good general condition in a female patient. In symptomatic cases, acute or chronic abdominal pain is the most common feature, whereas other symptomatology depends on the localization, size and consequential abdominal organ compression (intestinal obstruction, hydronephrosis, lower extremity lymphedema). The term of cystic mesenteric tumor is mostly used to refer to cystic lymphangiomas and lymphatic cysts. In the former, smooth muscle tissue is found, with endothelial lining towards the cavity. The wall of hilar mesenteric cysts does not contain smooth muscle tissue, however, they also show endothelial lining towards the cavity. Exact differentiation between these two entities is necessary for the disease prognosis. Lymphangiomas are prone to recurrence and infiltrating growth. The diagnosis should be made by use of all standard methods of abdominal tumor diagnosis, with ultrasonography (US) and computed tomography (CT), and especially nuclear magnetic resonance providing most information of the growth size and localization. Total cystectomy is the therapeutic method of choice. Open method has been preferred, although reports on successful cystectomy by the laparoscopic method have already appeared in the literature. CONCLUSION: Intraoperative differentiation between lymphatic cyst and lymphangioma is of utmost importance, and can only be achieved by pathohistologic examination of the cyst wall. If intraoperative biopsy cannot be performed or the finding is uncertain, each cyst should be extirpated in toto due to the above mentioned risk associated with cystic lymphangioma.
Adult↗
Mesenteric cysts in children.
Mesenteric cysts are rare intraabdominal lesions of childhood that may vary in presentation from an asymptomatic mass to an acute abdomen. From 1970 to 1990, 15 children were diagnosed and treated for mesenteric cysts at Ste Justine Hospital in Montreal. The ages ranged from birth to 18 years (average age, 6 years). There were 9 boys and 6 girls. Ten patients required emergency surgery and five underwent elective surgery. The main presenting symptom was abdominal pain. Ten patients had preoperative ultrasounds that were diagnostic for a cystic mass in all patients. The second most frequent preoperative diagnosis was appendicitis. The cysts were located in the small bowel mesentery in 5 cases, the base of the mesentery with retroperitoneal extension in 4 cases, the transverse mesocolon in 4 cases, and the gastrocolic ligament in 2 cases. Operative procedures performed included complete cyst excision (9 patients), complete excision with intestinal resection (5 patients), and drainage of the cyst (1 patient). The only recurrence in this series occurred after drainage. One other patient had recurrence of a mesenteric cyst following resection performed elsewhere. Mesenteric cysts are rare in children, are usually symptomatic, and are most commonly misdiagnosed as acute appendicitis. Accurate preoperative diagnosis is possible with current ultrasonographic imaging techniques. Complete cyst resection is the procedure of choice and results in an excellent outcome.
Abdominal Pain↗
Retroperitoneal and mesenteric cysts.
Retroperitoneal and mesenteric cysts are rare abdominal tumours. This report is a presentation of three cases. One patient had large retroperitoneal cyst which was accidentally discovered, another patient had mesenteric cyst presenting with abdominal pain, and the third patient had emergency admission due to infection of a large mesenteric cyst. The literature on this condition is reviewed.
Abdominal Pain↗
[Giant mesenteric cyst mimicking ascites].
Mesenteric cyst is a rare, benign lesion. A 59-year-old woman was admitted with abdominal distension. Physical examination and abdominal ultrasound indicated remarkable ascites. Aspiration revealed a clear transudate and computerized tomography showed a giant mesenteric cyst. At operation the cyst was removed. Giant mesenteric cysts can mimic ascites. This diagnosis should be included in the differential diagnosis of abdominal distension, even when ultrasound examination indicates ascites.
Ascites↗