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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

[Sonographic appearances of mesenteric cysts--report of 2 cases].

Mesenteric cyst is defined as a cystic mass located in the mesentery, and has rarely been reported. Before the clinical use of ultrasound (US), the imaging diagnosis of the abdominal mass depended on plain X-ray films and contrast examinations to delineate the space occupying lesion. The later use of US enables us to readily identify mass character. For example, whether it is cystic or solid, with or without septum, or whether there is sediment in the cyst. US examination is the method of choice in evaluating abdominal masses. Two cases of pediatric mesenteric cysts were brought to our hospital on account of complication. US of the first patient revealed a huge cystic mass with sediment and septae in central abdomen. Mild hydronephrotic change of the right kidney was found. The pathology showed nonepithelial lining multiloculated cyst surrounded by a thick, fibrotic granulomatous wall with suppurative cell infiltration and some calcifications. The histopathological diagnosis was an infected pseudocyst. The other patient had a cyst which twisted the jejunum and resulted in intestinal obstruction. US found dilated intestinal loops and a septate cystic mass in epigastrium. The pathology showed a multiloculated cyst with mesothelial lining, representing a mesothelial cyst. Both patients were treated surgically and had an uneventful recovery. In this article we described and explained the findings on US, discussed the differential diagnoses and compared different imaging modalities.

Abdomen

Carcinoma arising in a mesenteric cyst.

A report is presented in which a mesenteric cyst underwent a malignant change. A survey of the origin, symptoms, and treatment of mesenteric cysts is also included. The histologic picture of the case is described, the origin of the cyst discussed, and a comparison made with the two similar cases reported in the literature.

Abdominal Neoplasms

A case of mesenteric cyst diagnosed by ultrasound examination and a review of Japanese literatures.

Mesenteric cyst is relatively rare, and its diagnosis is difficult. We carried out an ultrasound examination on a 6-year-old boy who showed intestinal obstruction. This examination revealed an abdominal mass, and he was diagnosed as mesenteric cyst. Later it was confirmed by operation. The histopathological examination revealed that it was a lymphangioma. A review was also carried out on 288 cases of mesenteric cyst in Japan.

Child

Calcified mesenteric cyst.

Reported is a case of a calcified mesenteric cyst that was causing obstruction of the small bowel. Because only roughly one case occurs per 100,000 hospital admissions, mesenteric cysts are rarely thought of and may be difficult to diagnose. The differential diagnosis includes such critical lesions as aortic aneurysm, pancreatitis, ovarian cysts, omental cysts, and lipomas of the mesentery. The proper treatment of these rare lesions is somewhat influenced by causative factors: embryonic, traumatic, neoplastic, infectious, or degenerative. Surgical excision or enucleation is preferred to internal or external drainage. Ultrasonography is becoming increasingly valuable as a diagnostic tool.

Aged

Recurrent retroperitoneal mesenteric cyst. A case report and review.

A mesenteric cyst is an uncommon cause of a palpable abdominal mass. A correct preoperative diagnosis can be made by the combined use of radiographic and sonographic examinations in conjunction with the clinical features. A patient with a retroperitoneal cyst extending into the leaves of the mesentery is presented. The cyst recurred 4 years after surgery.

Child

Mesenteric cysts: a cause of small bowel obstruction in children.

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.

Child, Preschool

Case report: haemorrhagic mesenteric cyst mimicking appendicitis.

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.

Abdomen, Acute

[Intestinal obstruction and incomplete obstruction from mesenteric cyst formation in children (author's transl)].

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.

Child

Mesenteric cysts in infancy and childhood.

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.

Adolescent

Multiple mesenteric cysts diagnosed by ultrasound. A case report.

The diagnostic value of ultrasound in mesenteric cysts in infancy and childhood is demonstrated by a case report of a 4 year old girl with multiple cysts in the transverse mesocolon and with no other symptoms or signs than an enlargement of the abdomen. Neither clinical nor radiological examination could give the diagnosis, whereas ultrasound examination promptly revealed large, thin-walled, partly locular, cystic masses.

Child, Preschool

Sudden death in children due to mesenteric defect and mesenteric cyst.

Two cases of sudden death in young female children due to small intestinal volvulus are reported, which involved a mesenteric defect and a mesenteric cyst. Death due to small intestinal volvulus is uncommon, especially when complicated by either a mesenteric defect or cyst.

Child, Preschool

[Complicated mesenteric cysts in children].

Basing on the literature data and own experience with 9 patients the authors have come to the conclusion that mesenteric cysts occurred only in 0.01% of children operated on urgent indications. In 6 children surgical interventions were carried out for the clinical picture analogous to that of acute appendicitis, 3 patients were operated upon for the clinical picture of ileus.

Acute Disease

Case report: volvulus of a mesenteric cyst--an unusual complication diagnosed by CT.

A 10-year-old girl presented with colicky abdominal pain and a vague left sided mass on physical examination. Plain radiographs of the abdomen were unremarkable but ultrasound examination demonstrated a large right sided unilocular cystic abdominal mass. Computed tomographic features were diagnostic of volvulus of the proximal small bowel with associated mesenteric cyst. Surgery confirmed CT findings and no mid gut malrotation was noted at operation.

Child