Pseudoquiste mesentérico: reporte de un caso

Introducción: Los quistes mesentéricos se pueden encontrar a lo largo de todo el mesenterio del intestino. Los pseudoquistes de mesenterio se caracterizan por carecer de revestimiento endotelial. Generalmente son asintomáticos y el diagnóstico se realiza mediante estudios de imagen. Material y Método: Reporte de un caso clínico Resultados: Presentamos el caso de una mujer de 50 años sana que consulta por tumoración indolora en flanco izquierdo. Se solicita TC y RNM donde se visualiza tumoración quistica de paredes finas, homogenea de 88mm de diámetro mayor con septos y tabiques. Se realiza abordaje laparoscópico identificando masa de 12cm que se protruye a nivel del mesenterio de la segunda asa yeyunal, se reseca in incidentes. La anatomía patológica informó pseudoquiste mesentérico, sin elementos de malignidad. Buena evolución posterior. Conclusiones: Los quistes mesentéricos son extremadamente infrecuentes. General-mente se localizan en el mesenterio del intestino delgado como en el caso presentado. Teniendo en cuenta las características histopatológicas, se clasifican en seis grupos. Si bien es excepcional su transformación maligna, el tratamiento consiste siempre en su resección quirúrgica. Se prefiere la laparoscopía por sus conocidos beneficios.

Introduction: Mesenteric cysts can be found throughout the entire intestine mesentery. Mesenteric pseudocysts are characterized by lack of endothelial lining. They are generally asymptomatic and the diagnosis can be made by imaging studies. Material and Method: Report of a clinical case Results: We present the case of a healthy 50-year-old woman consulted for a painless tumor on the left flank. She requested a CT and MRI where a thin-walled, homogeneous cystic tumor of 88mm in greatest diameter with septa and partitions was visualized. A laparoscopic approach was performed identifying a 12cm mass that protruded at the level of the mesentery of the second jejunal loop, it was resected without incident. The pathological anatomy reported a mesenteric pseudocyst, without elements of malignancy. Good subsequent evolution. Conclusions: Mesenteric cysts are extremely rare. They are generally located in the mesentery of the small intestine, as in the case presented. Taking into account the histopathological characteristics, they are classified into six groups. Although its malignant transformation is exceptional, the treatment always consists of its surgical resection. Laparoscopy is preferred for its well-known benefits.

Quiste mesentérico gigante como simulador de ascitis: reporte de un caso y revisión de la literatura / Giant mesenteric cyst mimicking ascites: a case report and review of the literature

Introducción. Los quistes mesentéricos son tumores poco frecuentes y usualmente benignos, que se diagnostican principalmente en la edad pediátrica, de manera incidental.Caso clínico. Se presenta el caso de una paciente de cuatro años de edad, con dificultad para acceso a servicio de salud por localización de su vivienda, quien cursa con un cuadro clínico de dos años de evolución de distensión abdominal progresiva, interpretada y manejada como ascitis. Se realizó una tomografía de abdomen en la que se documentó una lesión quística gigante, por lo que fue llevada a resección por laparotomía, con confirmación histopatológica de un quiste mesentérico. Discusión. Los quistes mesentéricos pueden tener cualquier localización en el mesenterio del tracto gastrointestinal. Su principal etiología es la proliferación anormal y benigna de tejido linfático mesentérico. Las manifestaciones clínicas van desde la ausencia de síntomas hasta el abdomen agudo. Dentro de los síntomas abdominales no agudos se encuentran masa abdominal indolora, dolor abdominal, distensión abdominal y signos clínicos que simulan ascitis. La resección completa del quiste mesentérico es considerada el tratamiento de elección; el abordaje laparoscópico o abierto dependerá de las características clínicas de cada paciente y la experiencia del cirujano tratante. Conclusión. Es importante que los cirujanos conozcan las principales características y el manejo de esta entidad, que una vez presente, puede simular un síndrome ascítico.

Introduction. Mesenteric cysts are rare and usually benign tumors, which are diagnosed incidentally, mainly in children.Clinical case. We present the case of a 4-year-old patient, with difficulty accessing health services due to the location of her home, who has a 2-year history of progressive abdominal distension, interpreted and managed as ascites. An abdominal tomography was performed in which a giant cystic lesion was documented. She underwent resection by laparotomy, with histopathological confirmation of a mesenteric cyst. Discussion. Mesenteric cysts can have any location in the mesentery of the gastrointestinal tract. Its main etiology is the abnormal and benign proliferation of mesenteric lymphatic tissue. Clinical manifestations range from the absence of symptoms to an acute abdomen. Non-acute abdominal symptoms include a painless abdominal mass, abdominal pain, abdominal distension, and clinical signs that mimic ascites. Complete resection of the mesenteric cyst is considered the treatment of choice; laparoscopic or open approach will depend on the clinical characteristics of each patient and the experience of the treating surgeon. Conclusion. It is important for surgeons to know the main characteristics and management of this entity, which once present, can mimic an ascites syndrome

Quiste mesentérico gigante: reporte de caso / Giant mesenteric cyst. Case report

Resumen El quiste mesentérico es una patología intraabdominal poco frecuente, en su mayoría benigna. El tratamiento casi siempre es quirúrgico y consiste en la resección del quiste y de los órganos involucrados siempre que sea posible con el fin de reducir la tasa de recurrencia. Se presenta el caso de un paciente de 38 años con dolor abdominal inespecífico y diagnóstico ecográfico de masa retroperitoneal zona II izquierda gigante. Los estudios de extensión incluyeron tomografía axial computarizada, resonancia magnética y endoscopia de vías digestivas altas, cuyos hallazgos informaron una lesión quística gigante. Se realizó resección quirúrgica de la lesión por vía abierta, con diagnóstico histopatológico de quiste mesentérico.

Abstract A mesenteric cyst is a rare, mostly benign, intra-abdominal tumor. Treatment is almost always surgical and consists of removing the cyst and involved organs whenever possible to prevent recurrence. The following is the case of a 38-year-old patient with nonspecific abdominal pain and an ultrasound diagnosis of a giant retroperitoneal mass in the left medial paracolic gutter. The following imaging studies were performed: computed tomography, magnetic resonance, and endoscopy, finding a giant cystic lesion. An exploratory laparotomy was performed to remove the mass, and a histopathology report confirmed the diagnosis of mesenteric cyst.

Quistes del mesenterio en niños como causa de abdomen agudo / Mesenteric cysts in children as a cause of acute abdomen

RESUMEN Introducción: las masas abdominales en pediatría, pueden ser de diverso origen que incluyen patologías benignas y malignas. Los quistes mesentéricos son tumores intraabdominales raros. Se originan por el fracaso de los nódulos linfáticos intestinales en comunicar con los sistemas linfáticos o venosos. Presentación de casos: dos pacientes masculinos en edad pediátrica, de tres y 14 años de edad, que acudieron a urgencias son síntomas y signos de abdomen agudo, en el acto operatorio se encontraron quistes del mesenterio de diferente origen, los cuales fueron resecados. Ambos evolucionaron satisfactoriamente. Conclusión: los quistes del mesenterio son entidades que cuando se complican pueden ser causas de abdomen agudo en pediatría, su diagnóstico es difícil y mayormente ocurre durante el acto operatorio. La excéresis total brinda el menor índice de recurrencia.

ABSTRACT Introduction: abdominal tumors in pediatric ages can be of diverse origin including benign and malignant pathologies. Mesenteric cysts are rare tumors. They originate from the failure of the intestinal lymphatic nodules in communicating with the lymphatic or venous systems. Two-case report: three and 14 year-old male patients in pediatric ages, who came to emergency room with symptoms and signs of acute abdomen, at surgery mesenteric cysts of different origins were found, which were resected. Their evolution was satisfactory. Conclusion: mesenteric cysts are entities that when complicate can be causes of acute abdomen in pediatric ages, their diagnosis are difficult and mostly happens during the surgical procedure. The total resection of these cysts presents the least recurrence index.

Primary hydatid cyst of the mesentery presenting as a small bowel volvulus

Hydatid disease mostly caused by Echinococcus granulosus (dog tape worm) is a common parasitic disease in pastoral areas. It produces cysts in the human body. Human is an accidental intermediate host. Most common sites are liver and lungs. Intraperitoneal hydatid cyst occurs sometimes and it is usually secondary to rupture of primary hepatic hydatid cyst. Primary intraperitoneal hydatid cyst is rare (2%). Primary hydatid cyst in mesentery is very rare. Small bowel volvulus is rare but documented complication of tumours of the mesentery, including cysts. In this article, the authors present a case of primary mesenteric hydatid cyst with acute intestinal obstruction secondary to volvulus.

Management of rare and atypical inguinal hernias: our experience at a tertiary care centre

Background: Inguinal hernia is one of the most common surgical conditions operated by the surgeon. The purpose of the study paper was to provide diagnostic and therapeutic resources to deal with certain difficult situations in hernia repair.Methods: A retrospective analysis of 8 rare and atypical inguinal hernias was conducted for a period of 2 years at NRI General Hospital, which includes cases like Loss of domain hernias and hernias with atypical contents; which stood as diagnostic and management challenge to the surgeon.Results: Of the eight very rare and atypical cases operated, no postoperative complications were noted except one which developed a scrotal abscess after one month of discharge.Conclusions: The infrequent encounter with rare and atypical hernias stands a diagnostic challenge to the surgeon. Inguinal hernia repair even-though looks simple yet may sometimes be very difficult.

Think beyond ascites

In children with gross, persistent ascites wherein clinical scenario is not agreeable to common conditions, one needs to revise the diagnosis and rule out the surgical cause for abdominal distension mimicking ascites. We are reporting here, a case of two year old female child who presented with abdominal distension, clinically suggestive of ascites and subsequently diagnosed to have a large chylous mesenteric cyst which was determined on biochemical investigations, imaging and confirmed on surgical intervention. She was managed surgically with successful outcome.

Quiste de Mesenterio. Presentación de un caso / Mesentery cyst. Presentation of a case / Cisto de mesentério. Apresentação de um caso

RESUMEN Se presenta el caso de un paciente masculino de 9 años, ingresado en los servicios de pediatría y cirugía del Hospital General Peltier de la República de Djibouti, con diagnóstico de tumor abdominal gigante, el cual es intervenido quirúrgicamente y se realiza escisión completa del tumor quístico. El estudio anatomopatológico mostró quiste del mesenterio. Se revisa la literatura y se ofrecen consideraciones.

ABSTRACT We present the case of a 9-year-old male patient, admitted to the pediatrics and surgery departments of the Peltier General Hospital of the Republic of Djibouti, with a diagnosis of a giant abdominal tumor, which is operated on and a complete excision of the cystic tumor is performed. The anatomopathological study showed cyst of the mesentery. The literature is reviewed and considerations are offered.

RESUMO Apresentamos o caso de um paciente do sexo masculino, 9 anos, internado nos departamentos de pediatria e cirurgia do Hospital Geral de Peltier, República de Djibuti, com diagnóstico de tumor abdominal gigante, que é operado e completa excisão do tumor cístico. . O estudo anatomopatológico mostrou cisto do mesentério. A literatura é revisada e considerações são oferecidas.

Quisto mesentérico ­ uma raridade / Mesenteric cyst ­ a rarity

Os quistos mesentéricos são tumores intra-abdominais raros, com uma incidência descrita de 1/100 000 a 1/250 000 admissões hospitalares por dor abdominal. Localizam-se no mesentério do duodeno ao reto, principalmente no íleo. Os sintomas associados a estas massas não são específicos e a maioria dos casos são assintomáticos, sendo descobertos incidentalmente por exames de imagem ou durante exploração cirúrgica abdominal. O tratamento consiste na excisão cirúrgica e o diagnóstico é histológico. Apresenta-se o caso de um homem de 92 anos, internado num Serviço de Medicina Interna, que realizou uma angiotomografia axial computorizada abdominal que permitiu visualizar em localização sub-hepática uma lesão quística compatível com um quisto entérico de grandes dimensões constituído por 2 locas, sem comunicação, separadas pela vesícula biliar.

Mesenteric cysts are rare intra-abdominal tumors, with a reported incidence of 1/100 000 to 1/250 000 hospital admissions. They are located in the mesentery from duodenum to rectum, mainly in the ileum. The symptoms associated aren't specific and most cases are asymptomatic, being discovered incidentally during imaging tests or abdominal surgery. The treatment is the xcision of the cyst and the diagnosis is histological. We describe a case of a 92 years old man, admitted to the internal medicine service, which performed a computed tomography angiography that showed an infra hepatic cyst lesion compatible with an enteric multi-locular cyst, divided by the gallbladder.

Abdomen agudo quirúrgico secundario a Linfangioma quístico abdominal / Acute abdomen due to abdominal cystic lymphangioma

Los linfangiomas quísticos abdominales son benignos y poco frecuentes, que se presentan mayormente en niños. Puede presentarse como molestias inespecíficas abdominales, hallazgo incidental o abdomen agudo. Por lo que se presenta el caso de una niña de 3 años que debutó con un cuadro de abdomen agudo. (AU)

Abdominal cystic lymphangiomas are benign and infrequent conditions mostly seen in children. Clinical presentation is with non-specific manifestations or with an acute abdomen. We report here the case of a 3-year old girl presenting with an acute abdomen. (AU)

Diagnosis and Treatment of Mesenteric Cyst in Children / 现代医院

Objective To summarize the diagnosis and surgical treatment of mesenteric cyst in children.Methods The clinical records of mesenteric cyst cases from January 2011 to December 2015 were reviewed retrospectively.The diagnosis and treatment options were analyzed, and the prognosis of laparoscopic surgery and laparotomy was compared.Results The main clinical symptoms included abdominal mass, abdominal pain, and abdominal distension.Abdominal ultrasound and/or CT scan were the diagnostic tools in all cases.Traditional laparotomy was performed in 14 cases, while laparoscopy in 7 cases (1 case switched to laparotomy).2 cases had emergency surgery due to acute abdomen, laparotomy and laparoscopy in each case.Simple cyst resections were completed in 14 cases, of which 2 cases with a small amount of residual in the mesenteric root.Intestinal resection and anastomosis were required in other 7 cases.The average time of hospital stay for laparotomy group was 12 days, and 10.14 days for laparoscopy group.There was no significant difference.All patients were discharged without postoperative complications.With 1-4 years follow-up, there was no recurrence.Conclusion The operation for mesenteric cysts depends on the relationship between the cyst and the adjacent bowel or organs, and the overall outcome is favorable.The selective use of laparoscopy will benefit more children.

A Case of Mesenteric Cyst in a 4-Year-Old Child with Acute Abdominal Pain / 대한소아소화기영양학회지

Mesenteric cysts are rare intra-abdominal lesions occurring during childhood, which were first described in 1507. Cases of mesenteric cysts have been continuously reported, but these cases were very small in number. They are often asymptomatic and incidentally found while patients are undergoing work-up or receiving treatment for other conditions such as appendicitis, small-bowel obstruction, or diverticulitis; however, patients may still have lower abdominal pain and symptoms that are frequently associated with other abdominal conditions. The symptoms are variable and non-specific, including pain (82%), nausea and vomiting (45%), constipation (27%), and diarrhea (6%). An abdominal mass may be palpable in up to 61% of patients. We are to report the clinical course and literature of a child with mesenteric cysts who complained of acute abdominal pain, distension, and vomiting and were surgically treated after being diagnosed with mesenteric cysts based on radiological examination.

A Case of Mesenteric Cyst in a 4-Year-Old Child with Acute Abdominal Pain / 대한소아소화기영양학회지

Mesenteric cysts are rare intra-abdominal lesions occurring during childhood, which were first described in 1507. Cases of mesenteric cysts have been continuously reported, but these cases were very small in number. They are often asymptomatic and incidentally found while patients are undergoing work-up or receiving treatment for other conditions such as appendicitis, small-bowel obstruction, or diverticulitis; however, patients may still have lower abdominal pain and symptoms that are frequently associated with other abdominal conditions. The symptoms are variable and non-specific, including pain (82%), nausea and vomiting (45%), constipation (27%), and diarrhea (6%). An abdominal mass may be palpable in up to 61% of patients. We are to report the clinical course and literature of a child with mesenteric cysts who complained of acute abdominal pain, distension, and vomiting and were surgically treated after being diagnosed with mesenteric cysts based on radiological examination.

Presentación de un paciente con quiste mesentérico / Presentation of a Patient with Mesenteric Cyst

Se presentó un paciente masculino de 32 años de edad, de la raza blanca, con antecedentes de apendicectomía de 4 años, que acudió a la Consulta de Cirugía de Cuerpo de Guardia del Hospital Clínico Quirúrgico Lucía Iñiguez Landin de Holguín, porque comenzó a presentar dolor abdominal difuso desde hace 8 días, de ligera intensidad, después de un esfuerzo físico ligero, acompañado de aumento de volumen del abdomen específicamente en el hemiabdomen izquierdo y pérdida de peso de aproximadamente 14 libras en tres meses. Al examen físico se constata una masa tumoral que ocupa parte del hipocondrio y flanco izquierdo. Se realizaron estudios imaginológicos, que incluyó tomografía axial computarizada contrastada de abdomen y se sometió a laparotomía exploradora con diagnóstico preoperatorio de tumor de mesenterio, para realizar exéresis tumoral y estudio histológico, se concluyó como un quiste mesentérico. Se aplicó tratamiento con antibiótico y la evolución clínica es favorable.

A 32-year-old male patient with a history of four-year appendectomy. The patient came to the surgical emergency room at “Lucía Iñiguez Landin “Provincial Clinical Surgical Hospital because he started having a diffuse abdominal pain 8 days ago, with light intensity, after a slight physical effort, accompanied by an increase of de abdominal volume specifically on the left hemiabdomen. He has also lost approximately 14 pounds in three months. On the physical examination, a tumoral mass occupying part of the left hypochondriac and left flank was found. Image studies including contrasted abdominal CT-scan were performed. The patient was submitted to an exploratory laparatomy with a preoperative diagnosis of mesenteric tumor in order to remove it and carry out histological studies. The concluding diagnosis was a mesenteric cyst. The patient was treated with antibiotics. The clinical evolution was good.

A rare case of tubeculous mesenteric cyst.

We report a case of 17 year old female weighing 85 kg with chronic abdominal pain. Radiological imaging techniques revealed it as an enteric duplication cyst or mesenteric cyst. Diagnostic laparoscopy confirmed the cyst originating from mesentery. After laparoscopic excision of this cyst histopathology report was unusual, as a tuberculous mesenteric cyst.

Rare Presentation of a Mesenteric Cyst: A Surgical Dilemma.

Cystic lesions of the mesentery are rare conditions and usually present due to their complications. This makes their presentation diverse and diagnosis difficult. Mesenteric cysts of lymphatic origin are seen in bowel mesentery, more often small bowel; they are also seen in the omentum and the retro-peritoneum. One of the rarest presentations of a mesenteric cyst is in an inguinal hernia, and very few case reports are present in literature. We present a case of a 9-day-old baby boy who presented with a right inguinal hernia, the content of which at operation was a mesenteric cyst. We wish to highlight the dilemma faced by the surgeon in the operating room and the problem faced in taking operative decisions in the light of ethical management and medico-legal consequences.

Presentación de una paciente con quiste mesentérico / Presentation of a Patient with Mesenteric Cyst

Los quistes de mesenterio son patologías cuyo origen embriológico es múltiple y la presentación clínica no es clara, la mayoría de las veces se diagnostica en forma incidental o por exclusión de otras enfermedades. La tercera parte se diagnostica antes de los 15 años de edad y tiende a ser de naturaleza benigna, pero la recurrencia es alta cuando el tratamiento quirúrgico no reseca la totalidad de la lesión. El presente trabajo informó sobre una paciente de 17 años de edad que ingresó al Hospital Central de Benguela, Angola con el diagnóstico de tumor abdominal. Se realizaron estudios de imágenes los cuales no fueron concluyentes. En la laparotomía exploradora se encontró un quiste mesentérico, confirmado por estudio anatomopatológico. El tratamiento definitivo fue la exéresis del quiste.

Mesenteric cysts are pathologies whose embryological origin is multiple and clinical presentation is unclear, most often diagnosed incidentally or by exclusion of other diseases. The third part is diagnosed before 15 years of age and tends to be benign, but recurrence is high when surgical treatment does not dry the entire lesion. A 17-year-old patient was reported in this paper who admitted to the Central Hospital of Benguela, Angola with the diagnosis of abdominal tumor. Imaging studies which were conducted were inconclusive. In exploratory laparotomy one mesenteric cyst confirmed by pathologic study was found. The final treatment was the excision of the cyst.

Omental Cyst, an Uncommon Entity, and the Problems Faced: The Travails of a Surgeon: A Case Report.

Cystic lesions of the mesentery are uncommon lesions. They are difficult to diagnose and may be located anywhere along the gastrointestinal tract. However, they are most often seen in small bowel mesentery. Mesenteric and omental cysts are unique as they have a varied clinical presentation. They are diverse in etiology, radiologic features, and pathological characteristic. Omental cysts are rare and usually present with abdominal distension. Complete excision of the cyst is the treatment of choice. We report the case of a 4-year-old girl who presented with an acute abdomen. She had a short history that led to a laparotomy and complete excision of an infected omental cyst. We highlight the limitations in diagnosing the condition and the problems faced by the surgeon.

Neoplasia mucinosa quística del mesenterio: presentación de caso y revisión de la literatura / Mucinous cystic neoplasms of the mesentery: Case presentation and literature review

Las neoplasias quísticas mucinosas del mesenterio son infrecuentes, carecen de hallazgos clínicos específicos y usualmente se diagnostican incidentalmente como otros quistes mesentéricos. Presentamos el caso de una mujer de 67 años con un quiste mesentérico erroneamente clasificado en el preoperatorio como un tumor ovárico. Fue extraído completamente y la revisión histológica mostró un cistadenoma mucinoso. Revisamos la literatura y los casos reportados hasta la fecha.

Mucinous cystic neoplasms of the mesentery are rare, have a lack of specific clinical findings, and are usually diagnosed incidentally as other mesenteric cysts. The case is reported on a 67 year-old woman with a mesenteric cyst erroneously classified preoperatively as an ovarian tumor. It was completely resected and histological review showed a mucinous cystadenoma. A review is performed on the literature and cases reported to date.

Quiste gigante de mesenterio en un recién nacido: Reporte de un caso / Giant mesenteric cyst in a newborn: Report of a case

Se reporta el caso de una recién nacida, quien fuera ingresada al Servicio de Urgencia por distensión abdominal, dolor y vómito. Inicialmente se le dio manejo médico, pero posteriormente le fue identificada una masa en el hemiabdomen derecho que desplazaba a las vísceras. Es por ello que el Servicio de Cirugía Pediátrica decidió realizar intervención quirúrgica. En la cirugía, se encontró una tumoración a expensas del quiste de mesenterio, que posteriormente fue drenado en el transquirúrgico. El postoperatorio fue satisfactorio. El objetivo de este artículo es informar el caso de un neonato con un quiste de mesenterio y efectuar la revisión de la patología con la finalidad de establecer el abordaje diagnóstico y terapéutico. El quiste del mesenterio es una patología muy poco frecuente, el cual se define como cualquier lesión quística localizada en el mesenterio y se subdivide, según su origen, en tumores linfáticos, mesoteliales, urogenitales, dermoides, entéricos y pseudoquísticos. Los casos más frecuentes son los linfangiomas benignos producidos por la proliferación de tejido linfático ectópico. Generalmente se presentan en el mesenterio del intestino delgado o en el epiplón. Respecto al abordaje-diagnóstico, los estudios de imagen, para que sean de mayor utilidad, deben estar orientados con base en la historia clínica y la exploración física, siguiendo un orden en la realización de los mismos. El manejo definitivo es la exéresis o el drenaje, aun en casos asintomáticos.

We report the case of a newborn who was admitted for emergency service due to abdominal pain, distension and vomit. Initially medical treatment was given, but subsequently an abdominal mass was identified, so the pediatric surgery service decided to carry out a surgical intervention. At surgery a mass at the expense of mesenteric cyst was found. The cyst was drained in the trans-surgical. The postoperative course was satisfactory. The objective of the paper is to report the case of a newborn with a mesenteric cyst and review this pathology in order to establish the diagnosis and therapeutic approach. Mesenteric cyst is a rare disease defined as any cystic lesion in the mesentery. It is divided according to their origin in lymphoid tumors, mesothelial, urogenital, dermoid, and enteric pseudocystic. The most frequent cases are benign lymphangiomas produced by the proliferation of ectopic lymphoid tissue. Usually occur in small bowel mesentery or omentum. Regarding the diagnostic approach, the imaging studies should be oriented on the basis of clinical history and physical examination, following an order in conducting such studies. The definitive management is the excision or drainage, even in asymptomatic cases.