A rare presentation of mesenteric cyst as persistent ascites: A case report.

BACKGROUND: Mesenteric cysts have been typically described as cystic lesions of mesentery or omentum occurring either intra-abdominally or in the retroperitoneum. With no typical symptoms, the preoperative diagnosis of mesenteric cyst becomes challenging to establish. PATIENT AND METHODS: In this case report, we describe the case of a 29-year-old female who presented with abdominal distension for seven years associated with intermittent constipation. Following complete history, a meticulous physical examination was performed. Laboratory investigations and radiological imaging techniques were used to facilitate the diagnosis which was confirmed on laparotomy. RESULTS: Physical examination revealed abdominal ascites. Laboratory investigations were unremarkable. Abdominal ultrasound revealed multiloculated massive ascites. A well-defined cystic area 27 × 18cm displacing abdominal viscera was observed on computed tomography (abdomen and pelvis) with contrast medium. Exploratory laparotomy revealed a massive cyst involving almost the entire peritoneal cavity. On histopathology, no signs of malignancy were reported. The post-operative course was excellent, and the patient was discharged following surgery. CONCLUSION: As this lesion is rarely considered preoperatively, and the clinical manifestations can be non-specific, we report this case of mesenteric cyst mimicking ascites in order to inform improved decision making among healthcare professionals regarding the timely diagnosis and appropriate management.

Mesenteric Cyst with GI Symptoms: A Fluid Approach to Treatment-Case Report and Literature Review.

Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the gastrointestinal tract from the duodenum to the rectum. The clinical condition is entirely asymptomatic in many patients, particularly with small cysts. The diagnosis is typically incidental and secondary to imaging performed for other purposes. In symptomatic patients, the clinical picture is characterized by nonspecific gastrointestinal signs and symptoms. Treatment may be surgical or via interventional radiology. We report the case of a 55-year-old female patient complaining of left-sided abdominal discomfort and constipation lasting three months. An abdominal ultrasound showed the presence of a 10 × 14 × 16 cm anechoic cystic mass filling the whole anterior and left abdominal cavity, confirmed by CT and MRI. The cyst, removed laparoscopically, was histologically a simple mesothelial cyst. We reviewed the international literature over the last 10 years of all cases with mesenteric cysts > 10 cm in evaluating gastrointestinal symptoms at diagnosis, histology, performed treatment, and outcome.

First toddler mesenteric lymphatic malformation in Malaysia - A case report.

This is the first reported case of a mesenteric lymphatic malformation in a toddler in Malaysia. It is a rare benign condition with incidence of 1 in 250,000 populations. Our patient presented to us at 2 years 11months old complaining of abdominal distension for 6 months without obstructive symptoms. Clinically there was a vague soft central abdominal mass. CT abdomen done revealed a large multiloculated intraperitoneal mesentery cystic mass within the central abdomen extending to pelvis. A semi-emergency laparotomy was performed. Intra-operatively the multiloculated mesenteric cyst measured 20cm x 30cm, adherent to the small bowel beginning at 12cm from duodeno-jejunal junction. Resection of the mesenteric cyst with adherent small bowel and primary anastomosis was done. Histopathological examination revealed multiple large lymphatic channels of various sizes in the mucosa and submucosa. Our patient has no signs of recurrence and remains symptom-free after 1 year since his surgery. Surgery with clear margins of resection is the recommended gold standard based on available literature. Type of surgical resection required will depend on the type of mesenteric lymphatic malformation. An awareness of this rare pathology is required to ensure proper management is given to these patients.

[Surgical treatment of mesenteric cyst of small bowel]. / Khirurgicheskoe lechenie kisty bryzheiki tonkoi kishki.

A rare case of surgical treatment of mesenteric cyst of the small bowel is described. The diagnosis was confirmed by irrigography and contrast-enhanced computed tomography of the abdomen. The patient underwent small bowel and mesentery resection with subsequent entero-enteroanastomosis. Postoperative period was uneventful. This case confirms advisability of total en-bloc excision of the cyst via resection of intact mesentery and small bowel segment. Literature data indicate that the only treatment method for mesenteric cysts is surgery.

Amyand's hernia associated with mesenteric chylous cyst in infant: a rare case report.

BACKGROUND: Amyand's hernia is a rare condition approximately 0.4-0.6% of all inguinal hernias. Although rare, the Amyand's hernia is worthy of discussion since the variable presentation that make clinical challenge to diagnose especially in infant. A mesenteric chylous cyst is rare disease and has not been reported in Amyand's hernia. CASE PRESENTATION: We report an unusual case of Type II Amyand's hernia with an enlarging chylous mesenteric cyst on the retrocaecal in the anulus into canalis inguinalis. A-2-months old infant presented with enlarging mass in the right scrotal. During laparotomy exploration, we found inguinal sac with intestinal and appendix content in the sac. In the edge site of the sac we found enlarging of mesenteric cyst on the retrocaecal in the anulus into canalis inguinalis. Based on the histopathology examination, the morphological feature is suitable for mesenteric chylous cyst appearance. CONCLUSION: Presentation of mesenteric chylous cyst is rare, and there was no report about it in Amyand's hernia. This unusual presentation should be considered by the surgeon, especially pediatric surgeon, in Amyand's hernia cases.

Chylous mesenteric cyst in children -A case report in a 4-year-old boy.

Chylous mesenteric cyst is a very rare case, with some vague clinical findings, and it is hard to establish the diagnosis before surgery. The most common complaints post-surgery are abdominal pain and abdominal distention. We report a case of chylous mesenteric cyst in a 4-year-old boy with chief complaint of a lump in the abdomen. Preoperative abdominal ultrasound study could not identify the origin of the mass, and suspected it as a tuberculous peritonitis. A repeat ultrasound examination revealed a multicystic mass, suspected as lymphangioma. From the exploratory laparotomy, we noted a giant mesenterial cyst (20cm in diameter) containing chylous fluid within the ileal mesentery situated 30cm from the ileocaecal junction and made an effect of diminution of the bowel lumen above it, resection and end to end anastomoses was done. Histopathology examination confirmed it as a giant mesenteric cystic lymphangioma.

Clinical image. Chylolymphatic mesenteric cyst in a 3-month old infant.

Chylolymphatic mesenteric cysts are extremely rare among children. Herein we report a case of a 3-month old infant that was admitted to the Emergency Department due to repeated vomiting. Preoperative ultrasonography demonstrated the presence of a thin-walled multiloculated cystic lesion in the right abdomen. Patient underwent then elective surgical excision. Histopathological examination documented the diagnosis of cystic lymphangioma type III, according to Lozanoff classification.

Enterogenous cyst of the small bowel mesentery: a case report and review of the literature.

INTRODUCTION: Enterogenous cysts are a very rare congenital abnormality that can be found anywhere within the gastrointestinal tract, most commonly in the small intestine. The incidence is approximately one in 4500-10,000 live births. Diagnosis can be suggested by ultrasound (US), computed tomography (CT) scans or magnetic resonance imaging (MRI) findings, although histological examination confirms the definitive diagnosis. PATIENTS: We present a case of enterogenous cyst in an adult female who underwent a resection of the tumour. RESULTS: After two years of observation, there is no evidence of tumour recurrence.

Mesenteric cyst and recurrent abdominal pain in a patient with Gorlin-Goltz syndrome: a case report.

Gorlin-Goltz syndrome (GGS) is an infrequent autosomal do-minant multisystemic disease with complete penetrance and variable expressivity. It is estimated to have an incidence of 1:50,000 - 1:150,000 cases with a M/F = 1:1. This report describes a case of recurrent abdominal pain due to a large mesenteric cyst in a 38-year-old female patient affected by a rare disease: Gorlin-Goltz syndrome.

Benign mesothelial mesenteric cyst: case report and literature review.

A rare case of a benign mesothelial cyst arising from the mesentery of the descending colon is presented. A 73 year old female presented with an asymptomatic mesenteric cyst on CT scan. Colonoscopy revealed extrinsic compression of the descending colon. Surgical resection of the cyst necessitated partial colon resection due to the adherent nature of the cyst to the colon and its mesentery. The details of the case are presented as well as a brief review of the relevant literature.

[Multiloculated mesenteric and retroperitoneal tumour - lymphatic malformation - in a 4-year-old girl]. / Wielokomorowy guz krezki I prezestrzeni zaotrzewnowej - malformacja chlonna u czteroletniej dziewczynki.

Mesenteric cysts are rare and mostly benign abdominal tumours in children. Majority of them are lymphangiomas (lymphatic malformations). We diagnosed a broad, multiloculated mesenteric and retroperitoneal cyst, associated with intensive inflammation, in a 4-year-old girl. Surgical therapy was fully successful.

Anemia as One of Presenting Symptoms in an Adult with Cyst and Torsion of the Omentum - A Case Report.

BACKGROUND: Torsion is an uncommon disorder of the omentum and cysts are one of the rarest causes of omental torsion. To our knowledge, this is the first report of a case of an omental cyst presenting with both omental torsion and anemia. CASE PRESENTATION: We herein present a case report of a 41 year old indian female patient who presented with anemia (hemoglobin concentration 6.5 g/dL) and intermittent abdominal pain caused by torsion of a hemorrhagic omental cyst. A computed tomography scan, showed an omental cyst with free fluid in the abdominal cavity. At abdominal exploration, 1.5 L of hemorrhagic fluid was confirmed in the abdominal cavity. The cyst and twisted omentum were removed en bloc. The patient had an uneventful postoperative course and was discharged on day 8. At her 2-month follow-up, she was no longer anemic (hemoglobin concentration 10.7 g/dL). CONCLUSION: Cases of anemia associated with omental torsion have been reported in children; however, to the best of our knowledge, this is the first reported case of such a presentation in an adult. In such patients, surgical removal is the treatment of choice. Persons with recurrent abdominal pain and anemia must be assessed carefully and their differential diagnosis should include omental torsion. Appropriate diagnosis and treatment help avoid complications.

Laparoscopic resection of a jejunal mesenteric pseudocyst: case report.

Mesenteric cysts are rare and can occur at any age. They can manifest with abdominal pain or compressive mass effect. The exact etiology is unknown. Ultrasonography, computed tomography and laparoscopy are used in diagnosing mesenteric cysts. Laparoscopic excision of a mesenteric cyst is possible and should be considered as the treatment of choice. We present a case of mesenteric pseudocyst of small bowel treated by laparoscopic excision.

[Chylous mesenteric cyst]. / Chylózní mezenteriální cysta.

The authors present a case report of a female patient with a recurrent mesenteric cyst. Chylous cyst is one of rare diagnoses of a cyst close to the pancreas in patients with no history of acute pancreatitis. Chylous cysts need to be managed radically; otherwise, given their nature, they are likely to recur.

[Pathologic fluid collection of mesentery, differential diagnosis of mesenteric cysts - case report]. / Patologická tekutinová kolekce mezenteria, diferenciální diagnostika mezenteriální cysty - kazuistika.

Mesenteric cyst is a pathologic fluid collection that very rarely occurs anywhere in the mesentery of the gastrointestinal tract from the duodenum to the rectum. The etiology of mesenteric cysts has not yet been completely understood. It ranges from tumorous, infectious, lymphatic and embryological to post-traumatic or post-operative origin. Symptoms of the illness are usually non-specific, caused mainly by intestinal obstruction. Diagnosis is often accidental. Therapy is exclusively surgical. In the following text, the authors present a case report of a 50-year-old patient operated on due to a mesenteric cyst. The patient had undergone bilateral nephrectomy for polycystic kidney disease and was followed up for polycystic liver disease. CT accidentally revealed a mesenteric cyst around 14 cm in size in the right meso-hypogastrium. It was necessary to perform its histological verification before the planned renal transplantation.

Anatomo-clinical analysis of 14 consecutive cases of primary cystic mesenterico-epiploic tumors.

BACKGROUND: The aim of this study is an anatomo-clinical evaluation of the primary cystic mesenterico-epiploic tumors,based on a single-center's 15 year experience. MATERIAL AND METHOD: We performed a retrospective study of a series of 14 primary cystic mesenterico-epiploic tumors that were operated in the Surgical Department 4 UMPh Targu-Mures, Romania, between 01.01.1997 and 01.01.2012. Data about the clinical complaints, imagistic aspects, associated lesions, surgical approach, hospitalization, pathology, and immediate and late postoperative course were recorded and analysed using the Microsoft Excel software. RESULTS: In all cases we performed a complete and intact surgical excision, using an open approach in 13 cases and laparoscopy in 1 case, with no mortality and no significant surgical-related morbidity; we have encountered a single recurrence at 1.5 years after surgery. We had no preoperative pathological diagnosis; the exact preoperative anatomic location of the tumor was possible only in one case. Pathologic examination showed the following types: inclusion cysts - 4 cases, enteral duplication cysts - 2 cases, simple mesothelialcysts - 6 cases, cystic lymphangioma - 1 case and simple lymphatic cyst - 1 case. We have systematized 3 clinicoimagistic patterns according to the dimension of the tumor,with no relationship to the histologic origin of the tumor. CONCLUSIONS: Primary cystic mesenterico-epiploic tumors aredifficult to diagnose preoperatively. Complete excision is usually possible, even for large tumors. These relatively rare tumors must be considered in the differential diagnosis of cystic abdominal masses.

Feasibility of laparoscopic resection of mesenteric cysts: two case reports.

INTRODUCTION: Mesenteric cysts (MC) are rare intra-abdominal tumors. The incidence has been estimated to be 1/100000 in the adult population and 1/20000 in children, with a male: female ratio of 1:1. The first successful laparoscopic resection of a MC was reported by MACKENZIE et al. in 1993. The malignant transformation appears in 3% of cases. In our study, we presented the feasibility and results of laparoscopic resection. CASE REPORTS: We report two cases of mesenteric cysts removed by a laparoscopic procedure. RESULTS: Laparoscopic approach in the two cases was successful. No conversion was observed. No complication occurred. The histopathological studies revealed no malignancy. After 18 months of follow-up the 2 patients remained free of disease. CONCLUSION: In selected cases, safe and complete resection of MC could be achieved by laparoscopic approach. Complete surgical resection of MC is the treatment of choice when the cyst becomes symptomatic or when complications occur.

[Mesenteric cyst in the Instituto Nacional de Salud del Niño, Lima, Peru: a case report]. / Quiste mesentérico en el Instituto Nacional de Salud del Niño, Lima, Perú: reporte de caso.

Mesenteric cysts are rare abdominal tumors. About 60% of these cysts occurs before 5 years of age and can be located anywhere in the gastrointestinal tract, but are most often found in the small bowel mesentery. The clinical presentation depends on the location and size of the cyst and many cases are asymptomatic and are diagnosed incidentally. The most common symptoms are abdominal pain, bloating, abdominal mass, nausea, vomiting, constipation, diarrhea, weight loss, fever and peritonitis. Complications include torsion, infarction, volvulus formation, perforation, infection, anemia, intracystic hemorrhage, intestinal obstruction and obstructive uropathy. They are typically treated by simple excision, marsupialization or segmental bowel resection and have excellent long-term prognosis.

Surgical Treatment of Mesenteric Lymphatic Malformations in Children: An Observational Cohort study.

BACKGROUND: Few studies have analyzed the cyst characteristics and complications of mesenteric lymphatic malformations (ML). This study aimed to compare ML's cyst characteristics and preoperative complications at different locations and suggest a modified ML classification for patients requiring surgery. METHODS: In total, 157 ML patients underwent surgery at Beijing Children's Hospital between January 2010 and December 2021. The cyst characteristics and preoperative complications were reviewed. The surgical methods for ML were analyzed according to the modified ML classification (Type I, n = 87, involving the intestinal wall; Type II, n = 45, located in the mesenteric boundaries; Type III, n = 16, involving the root of the mesentery; Type IV, n = 7, multicentric ML; Type V, n = 2, involving the upper rectum). RESULTS: Overall, 111 (70.7%) ML were located at the intestinal mesentery and 44 (28.0%) at the mesocolon. Type I and type II ML mainly involved intestinal mesentery (64.9%) and mesocolon (56.8%), respectively (P < 0.001). Microcystic-type ML and ML with chylous fluid were only located in the intestinal mesentery. Intestinal volvulus was only found in patients with ML in the intestinal mesentery (P < 0.001), whereas ML in the mesocolon were more prone to hemorrhage (P = 0.002) and infection (P = 0.005). ML in the jejunal mesentery was an independent risk factor for intestinal volvulus (OR = 3.5, 95% CI 1.5-8.3, P = 0.003). The surgical methods significantly differed between Type I and type II ML (P < 0.001). CONCLUSIONS: ML at different locations have different characteristics. For patients requiring surgery, the new ML classification can be used to select an appropriate surgical method. LEVEL OF EVIDENCE: Level III.