Mesenteric cyst lymphangioma as an abdominal emergency. Mesenteric cysts are indeed rare, and have been omitted from some surgical textbooks. A histopathological diagnosis of mesenteric cystic. Preoperative diagnostic tools are ultrasound and abdomen ct or mr. This pathology is usually found in the head and neck. When a mesenteric mass is identified at imaging, the first step is to determine if the lesion is a solid mass or a cyst.
An enteric duplication cyst is a unilocular cyst with an enhancing wall on ct. Epidemiology mesenteric cysts are rare, with a reported incidence of 0. Discussion mesenteric cysts are one of the rare cyst observed in abdomen. No postoperative complication was observed in patient. We present a case of mesenteric cyst that was misdiagnosed as paraovarian cyst and managed laparoscopically by gynaecologists. He had a 5month history of abdominal pain from this disorder, and the case is presented to illustrate the clinical picture and operative management of this rare disorder. A case of mesenteric cyst in a 4yearold child with acute. Here we report a case of mesenteric cyst confused with ovarian endometrioma. Consequently, inappropriate treatment and late diagnoses are common in the management of mesenteric cysts. Presentation with nontyphoid spontaneous infection in an unusual area makes it even more a rare situation with mesenteric cyst.
Its diagnosis is mainly based on the imaging modalities. The other case had the appearance of loculated, septated ascites. Histopathological examination of the cyst revealed it to be an unclassified pleomorphic sarcoma of mesentery. It may vary in presentation from an asymptomatic mass to an acute abdomen. Large, irregular vascular spaces similar to cavernous hemangioma, may resemble cysts lined by flattened, bland epithelial cells cystic and cavernous lymphangiomas are usually considered the same entity. Mesenteric cyst definition of mesenteric cyst by the. Jun 15, 2019 mesenteric cysts are rare benign intraabdominal tumors with an incidence of 1 case per 250,000 hospital admission. And the final pathophysiologic result wa s a lymphatic mesenteric cyst fig. Giant abdominal mesenteric cyst bioline international. Optimal treatment is surgical excision of the cyst with laparotomy or laparoscopy. Variable presentations of mesenteric and omental cysts in infancy. Mesenteric and omental cysts are rare intraabdominal pathology.
Features of ovarian remnant syndrome for mesenteric cystovarian implant syndrome are. Histopathology revealed tuberculosis in 23 patients, reactive adenitis in 2, lymphoma in 1 metastatic. Omental cysts are located in the lesser or greater omentum. Mesenteric cyst must be differentiated from gastrointestinal duplications. The incidence has been estimated to be 1 in 100,000 in the adult population and 1 in 20,000 in the pediatric population. Sclerosing mesenteritis is a rare, nonneoplastic inflammatory and fibrotic disease that affects the mesentery. They are difficult to diagnose accurately on imaging and should be treated with complete excision, rather than drainage because of the risk of missing the diagnosis of a borderline mcn, recurrence and malignant transformation. Mesenteric cyst of abdomen in a young girl a rare entity. In 1880 tillaux performed the first successful resection on a cystic mesenteric tumor 3.
Their macroscopic cystic characteristics give a wide range of differential. Case was diagnosed as mesenteric cyst due to the histopathologic examination. Pdf mesenteric cysts are uncommon benign abdominal lesions with no classical clinical features. Solid masses are usually neoplastic, whereas lesions that are entirely cystic are typically benign.
The cyst was completely removed and histology report confirmed mesenteric cyst without. During the laparoscopic exploration, it was noted that the mesenteric cyst was in the left lower quadrant. Benevieni, an italian anatomist, was the first person to detect a mesenteric cyst in 1507, while performing an autopsy on an 8yearold boy. Chylous lymphatic cyst in a childa rare variant of mesenteric cyst aditya pratap singh, arun kumar gupta, maryem ansari, ramesh tanger department of pediatric surgery, s. The relevant discussion focuses on the clinical features, diagnosis, treatment and outcome of patients with paraovarian cysts. Mesenteric cysts are rare benign intraabdominal tumours with an. Mesenteric cysts have similar pathogenesis, but may have different histopathological origin and structure. Mesenteric cysts atlas of swine pathology pig333, pig. The cysts may be quite large, and the primary symptoms are abdominal pain and abdominal distention. Mesenteric cyst can occur at any site in the mesentery of gastrointestinal tract from duodenum to rectum. Hydatid cyst and ovarian cystic lesions can be considered in differential list. However, exploratory laparotomy revealed it to be a paraovarian cyst.
This report aims to discuss current diagnostic and treatment strategies. No hair or other structures were found in the cyst contents. Sclerosing mesenteritis can affect the integrity of the gastrointestinal lumen and mesenteric vessels by a mass effect. Mesenteric cysts are one of the rare cyst observed in abdomen. Mesenteric cyst lymphangioma as an abdominal emergency in a. Florentine anatomist benevieni first described a mesenteric cyst in 1507, while performing an autopsy on an 8yearold boy. Giant mesenteric cyst cause of abdominal distension managed. Mesenteric cyst causing acute intestinal obstruction. Mesenteric cysts are a very rare cause of abdominal pain and have a wide range of underlying causes. Chylous lymphatic cyst in a childa rare variant of. Medical college and group of hospitals, jaipur, rajasthan, india. Mesenteric lymphangioma in adult is a rare disease.
It was a thin walled structure, with yellow fluid, and was fixed to the mesentery posteriorly, with no other points of attachment figure 3. Mesenteric cysts are uncommon but will be seen by most practicing surgeons. The lining of mesenteric cyst either endothelium or mesothelial cell 1. Definitive diagnosis is confirmed by histopathology.
Laparoscopic biopsy in patients with abdominal lymphadenopathy. These anatomical structures are all lined by peritoneum and composed of connective. Mesenteric cysts are cystic mesenteric lesions that can be further characterized by the wall thickness thin or thick walled and their loculation unilocular or multilocular. Complete surgical excision of the cyst is the treatment of choice 4 surgical excision is considered the mainstay for therapy, as recurrence of the cyst can occur with lesser procedures. Most often they represent ectopic lymphatic tissue. We report a case of simultaneous huge splenic and mesenteric hydatid cyst in a 91yearold male patient. An abnormal membranous sac in the body containing a gaseous, liquid, or semisolid substance. The italian anatomist benevieni was the first one who published about mesenteric cyst following an autopsy. Mesenteric cysts can occur anywhere in the mesentery, from the duodenum to the rectum, and may extend into the retroperitoneum. Giant mesenteric cyst cause of abdominal distension managed with laparotomya case report nguyen m1, faul p2 and naqvi sa1 1department of surgery, university hospital limerick, ireland 2department of pathology, university hospital limerick, ireland.
In five patients with chronic right lower abdominal pain and normal ultrasonographic findings mesenteric nodes were identified and biopsied during diagnostic laparoscopy. Laparoscopic excision of large mesenteric cyst from the. Midline laparotomy reveals a large mesenteric cyst just beneath the fascia. Nov 21, 2011 a correct preoperative diagnosis of mesenteric cyst is rarely made at least without a modern ultrasound or ct scan evaluation. After 9 months, another cyst appeared on ultrasound. Mesenteric cysts are rare benign intraabdominal tumors with an incidence of 1 case per 250,000 hospital admission. Ten patients had working ports in the midline on either. The cyst was closely related to bowel wall with mesenteric blood vessels crossing over it, and separation was difficult figure 1. The response of pathology was compatible with a mesenteric cyst. In 1880, tillaux was the first to describe successfully resecting a mesenteric cyst.
Hanganu e1, gavrilescu sl, trandafirescu mf, chiforeanu am, mihaila d, florea id, antonpaduraru dt, burlea m. No luminal communication was found between this cyst and the cecum. To highlight aspects of the disease and its value in children with recurrent abdominal. Histopathology mesenteric cyst lymphangioma is characterized by a thin irregular wall covered by endothelium and contains smooth muscle, foam cells and lymphatic tissue. Fibrosis with dense collagen, fat necrosis, chronic inflammation especially around vessels and variable focal calcification. Laparoscopic excision of large mesenteric cyst from the small. Dermoid cyst mature cystic teratoma of the cecum archives.
This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. Symptoms relate to the size and location of the cyst rather than to the specific pathology of the cyst until complications occur. The patient showed irregular menstruations only, and no other specific symptoms were noted. In addition, a solid appearance with a honeycomb pattern of internal echos was observed in one case. Mesenteric cyst lymphangioma as an abdominal emergency in. Realtime ultrasound demonstrated the typical appearance of welldefined, anechoic masses.
Mesenteric cysts can occur in the mesentery anywhere along the gastrointestinal tract from the duodenum to the rectum. Histopathological examination showed that cyst wall was lined by. Exploratory laparotomy revealed a sigmoid mesenteric cyst protruding out of one of the mesenteric leaves and attached to it by a narrow stalk. Even today the literature reports on primary cystic tumors of mesentery are relatively rare.
Some authors describe chylolymphatic cyst as a variant of mesenteric cyst 11. A clockwise torsion of the cyst, leading to a constrictive narrowing of the adjacent small bowel loop was noted. Mesenteric cyst lymphangioma is characterized by a thin irregular wall covered by endothelium and contains smooth muscle, foam cells and lymphatic tissue. Simulator that calculates the amount of drug to add to the water when using a flow dispenser. Mesenteric cysts are rare, fluid filled sacs attached to the mesentery, the tissue from which the intestines hang.
Laparoscopy is regarded as a feasible method in selected patients 10. We herein present a rare case of a mesenteric cyst in a neonate causing obstructive uropathy and secondary type 1 pha. A 35yearold woman presented with nonspecific abdominal pain. Mesenteric duplication cyst, a rare cause of recurrent. Cystic lymphangioma has a striking resemblance to chylolymphatic mesenteric cyst microscopically. Histopathology report showed that it was mesenteric cyst discussion mesenteric cysts are uncommon benign abdominal masses first described by benivieni in 1507,7 although 3% are found to be malignant. Histopathological examination revealed a thick fibrous cyst wall with the signs of chronic inflammation and. Mesenteric cyst on the basis of internal content is divided into two categories, lymphatic and serous 2. Mesenteric cyst can present with few uncommon emergency. Mesenteric cysts are rare intraabdominal lesions with variable clinical symptoms and signs that make preoperative diagnosis difficult. A mesenteric cyst in the sigmoid mesocolon is even rarer. A correct preoperative diagnosis of mesenteric cyst is rarely made at least without a modern ultrasound or ct scan evaluation. Pathology outlines cystic cavernous lymphangioma cystic.
Rajendran s, khan a, murphy m, hanlon do 2014 the diagnosis and treatment of a symptomatic mesenteric cyst. After him, pean reported the first marsupialization of a mesenteric cyst in 1883. The sites of biopsied lymph nodes included paraaortic 10, mesenteric 8, or c previously undiagnosed lymphadenopathy is. The objective of this study is to discuss the presentation, diagnosis, and surgical management of a young, healthy patient with a symptomatic mesenteric cyst. However, the subject deserves more consideration because of the very fact that the cysts are frequently overlooked. Ros pr, olmsted ww, moser rp jr, dachman ah, hjermstad bh, sobin lh.
There was no history of fever, convulsions, vomiting or diarrhoea and the infant was exclusively breastfed. Mesothelial and enteric cysts are anechoic, thinwalled cysts. Fortyone cases of mesenteric and omental cysts are reported. Histopathology confirmed it to be serous cystadenoma. Sectioning revealed a uniloculated cyst measuring 8 cm with a thin uniform wall 0. The cyst was mobilized from the mesentery using the harmonic shears and a suction irrigator.
Complete surgical resection is the ideal modality of treatment for mesenteric lymphangioma. Mesenteric cysts are rare, abdominal tumors, and they are benign growths with malignant transformation reported in 3% of cases. The specimen was sent to cytopathology which revealed benign mesenteric cyst fluid containing macrophages with cyst contents. The cyst contained clear fluid and had a smooth inner surface. They are also poorly understood clinical entities that are difficult to classify. In 1907, the italian anatomist benevieni first reported a mesenteric cyst following an autopsy on an 8yearold girl. Mesenteric cyst is a rare cystic disease that occurs within the abdominal cavity, with a prevalence of 1100 000 to 250 000 among adult hospitalised patients. Mullerian cysts arise from the fused embryonic ducts, which typically regress in the uterus we report a case of a 42yearold female who presented in emergency with acute abdominal pain in right iliac fossa. Mesenteric dermoid cyst in a child pubmed central pmc. Duplications have common blood supply, intimately associated with bowel wall, and contains well defined muscular wall 9.
Mesenteric fibromatosis is the most common among the intraabdominal fibrosis group. Giant mesenteric cyst cause of abdominal distension. The incidence is between 1 per 100,000 to 1 per 250,000 hospital admissions. Jun 29, 2001 sectioning revealed a uniloculated cyst measuring 8 cm with a thin uniform wall 0. Hydatid disease hd is caused by echinococcus granulosus and is endemic in many parts of the world. Simultaneous huge splenic and mesenteric hydatid cyst. Laparoscopic biopsy in patients with abdominal lymphadenopathy d s bhandarkar, r s shah, a n katara, m shankar, v a chandiramani, t e udwadia.
Mesenteric cyst is defined as a cystic lesion located. The diagnosis and treatment of a symptomatic mesenteric cyst. Mesenteric cysts are one of the most rare intraabdominal tumors. Despite its rarity, mesenteric fibromatosis is the most common mesenteric tumor 2.
The etiology of such cysts remains unknown but several theories regarding their development exist 1. Mass signal characteristics, morphology, and enhancement pattern can help further narrow the differential diagnosis. In contrast, mesenteric cyst has an endothelial lining, less vascular, thin wall 10. A histopathological diagnosis of mesenteric cystic lymphangioma, clinically misdiagnosed as simple mesenteric cyst case report. The diagnosis and treatment of mesenteric cysts is challenging due to rarity, lack of specific symptoms and variability in location and size. Emphasis is placed on the importance of identifying lymphangioma, which is more difficult to manage than the other forms of mesenteric and omental cysts. However, there are difficulties in diagnosis when it is present in an uncommon area and rare known complications. Mesenteric duplication cyst is a rare cause of recurrent abdominal pain and abdominal mass in a child. After classifying mesenteric and omental cysts histopathologically table 3 we found that in this present study only 6 cases were diagnosed as omental cysts in comparison to 49 cases of mesenteric cysts, indicating that omental cysts are rarer than mesenteric cysts. The author encountered four cases of mesenteric fibromatosis over a period of 6.169 302 520 1235 1305 1099 82 837 171 49 875 1051 1417 949 245 118 1314 74 333 120 953 1097 2 1068 1303 485 700 1231 843 1029 843 316 1350 568 762 1324