[Mesenteric cyst--clinical and pathological aspects]. / Cisto mesentérico--aspectos clínicos e anátomopatológicos.

OBJECTIVE: To evaluate epidemiologic, clinical, pathologic and therapeutic characteristics of the mesenteric cysts in hospitals of Sergipe, Brazil. METHODS: Mesenteric cysts were assessed by a non-interventional cross-sectional study from the archives of the Pathology Laboratory of Federal University of Sergipe between 1995 and 2007. The charts of the patients were reviewed in order to find out: gender, age, clinical findings, complementary exams and therapeutic approach. RESULTS: Eighteen cases of mesenteric cysts were found. Females were more affected (72.2%). Mean of age of the patients was 30.46. More frequent symptoms were pain and abdominal mass. Ultrasonography of abdomen, performed in all patients, was not conclusive in half of the cases. CTscan of abdomen with contrast was performed in six cases, being cystic tumor well identified in all of them. Regarding histopathology, 6 lymphangiomas, 8 mesotheliomas, 1 hemorrhagic cyst in organization and 1 mucinous cyst were found. Surgical treatment was performed in all cases. Intracystic bleeding was the main complication in 3 cases. CONCLUSION: The mesenteric cysts presented clinically with unspecific symptoms. CTscan was more effective than ultrasonography for the diagnosis. Lymphangiomas and mesothelioma had been found in equal ratios. The complete resection of the cyst was the treatment of election. There were no deaths in postoperative period.

Early management of mesenteric cyst prevents catastrophes: a single centre analysis of 17 cases.

BACKGROUND: Mesenteric cysts are rare intra-abdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal symptoms. PATIENTS AND METHODS: Seventeen patients (age less than 10 years) with mesenteric cysts were managed in our hospital. The age ranged from 15 days to 10 years. Patients were admitted with acute or chronic symptoms. They were evaluated with complete history, clinical examination, blood investigations and radiological investigations (x-ray abdomen erect, ultrasound abdomen (USG) and computed tomography (CT) scan in selected cases) to reach a provisional diagnosis. The diagnosis was proven on laparotomy and histologically confirmed. RESULTS: The main presenting symptoms were abdominal pain or lump. The most common mode of presentation was acute small intestinal obstruction. USG was not conclusive in all. Abdominal CT scan with intravenous contrast was diagnostic in nine patients. Five patients had volvulus on exploration. Cysts were located in small intestinal mesentery in 14 cases and three were in the sigmoid mesentery. Seven patients had complete excision, intestinal resection was required in four and marsupialisation with cauterisation of margins was done in six patients. Histologically, all were lymphangiomatous mesenteric cysts. CONCLUSION: The diagnosis of mesenteric cysts should be kept in mind in any patient presenting with acute abdominal symptoms. Small bowel volvulus with mesenteric cyst constituted a significant number in children with acute abdominal symptoms. Early diagnosis and treatment yields excellent outcome.

Cisto mesentérico: aspectos clínicos e anátomopatológicos / Mesenteric cyst: clinical and pathological aspects

OBJETIVO: Discutir aspectos epidemiológicos, clínicos, anátomo-patológicos e terapêuticos de cistos mesentéricos atendidos em hospitais do Estado de Sergipe. MÉTODOS: Estudo observacional, descritivo e transversal, consistindo de um levantamento de uma série de casos de cistos mesentéricos, nos arquivos do Laboratório de Patologia da Universidade Federal de Sergipe no período de 1995 a 2007. Revisaram-se os prontuários dos pacientes para coleta de dados: gênero, idade, quadro clínico, exames complementares e abordagem terapêutica. RESULTADOS: Foram encontrados 18 casos de cistos mesentéricos. O gênero predominante foi o feminino (72,2 por cento). A média de idade dos pacientes ao diagnóstico foi de 30,48 anos. Os sintomas mais freqüentes foram dor e massa abdominal. A ultra-sonografia de abdome, realizada em todos os pacientes, não foi conclusiva em metade dos casos. Tomografia computadorizada de abdome com contraste foi realizada em seis casos, sendo a tumoração cística bem evidenciada em todos estes. Quanto ao tipo histopatológico foram encontrados oito linfangiomas, oito cistos mesoteliais, um cisto hemorrágico em organização e um cisto mucinoso. O tratamento cirúrgico foi empregado em todos os casos. Hemorragia intracística foi a principal complicação apresentada, ocorrendo em três casos. CONCLUSÃO: Os cistos mesentéricos apresentaram-se clinicamente com sintomas inespecíficos e pouco sintomáticos. Quanto ao diagnóstico, a tomografia computadorizada mostrou ser mais efetiva que a ultrassonografia. Linfangiomas e mesoteliomas foram encontrados em proporções iguais. A ressecção completa do cisto foi o tratamento de eleição e não houve óbitos no pós-operatório.

OBJECTIVE: To evaluate epidemiologic, clinical, pathologic and therapeutic characteristics of the mesenteric cysts in hospitals of Sergipe, Brazil. METHODS: Mesenteric cysts were assessed by a non-interventional cross-sectional study from the archives of the Pathology Laboratory of Federal University of Sergipe between 1995 and 2007. The charts of the patients were reviewed in order to find out: gender, age, clinical findings, complementary exams and therapeutic approach. RESULTS: Eighteen cases of mesenteric cysts were found. Females were more affected (72.2 percent). Mean of age of the patients was 30.46. More frequent symptoms were pain and abdominal mass. Ultrasonography of abdomen, performed in all patients, was not conclusive in half of the cases. CTscan of abdomen with contrast was performed in six cases, being cystic tumor well identified in all of them. Regarding histopathology, 6 lymphangiomas, 8 mesotheliomas, 1 hemorrhagic cyst in organization and 1 mucinous cyst were found. Surgical treatment was performed in all cases. Intracystic bleeding was the main complication in 3 cases. CONCLUSION: The mesenteric cysts presented clinically with unspecific symptoms. CTscan was more effective than ultrasonography for the diagnosis. Lymphangiomas and mesothelioma had been found in equal ratios. The complete ressection of the cyst was the treatment of election. There were no deaths in postoperative period.

Quiste del mesenterio: reporte de un caso y revisión de la literatura / Mesenteric cyst: a case report and literature review

El quiste mesentérico es una entidad poco frecuente que se ha definido como cualquier lesión quística localizada en el mesenterio, y se subdivide, según su origen, en tumores linfáticos, mesoteliales, urogenitales, dermoides, entéricos y seudoquistes. Recientemente atendimos en nuestro hospital a un paciente del sexo masculino, de 61 años de edad, ingresado a causa de dolor abdominal difuso, que se llevó al salón de operaciones con el diagnóstico de oclusión intestinal por bridas. Durante el acto quirúrgico se encontró un quiste del mesenterio, aproximadamente de 8 a 10 cm, por lo que fue necesario realizar una resección intestinal, siendo la evolución posoperatoria favorable. La baja incidencia de la enfermedad y la creencia errónea de que se trata de un proceso benigno y asintomático han contribuido al escaso interés por su conocimiento(AU)

The mesenteric cyst is an uncommon entity localized in the mesentery and it is subdivided, according to its origin into lymphatic, mesothelial, urogenital, dermoid, or enteric tumors, and pseudocysts. Recently. we received in our hospital a 61-year-old male patient that was admitted due to a diffuse abdominal pain. He was taken to the operating room with the diagnosis of intestinal occlusion caused by bands. During the surgical procedure, it was found a mesenteric cyst of approximately 8-10 cm, which made necessary to perform intestinal resection. The postoperative evolution was satisfactory. The low incidence of the disease and the erroneous belief that it is a benign and asymptomatic process have contributed to the little interest in knowing about it(AU)

[Mesenteric cyst. A review]. / Quiste de mesenterio. Revisión.

The mesenteric cyst is a tumor of multiple origins, that undoubtedly presents with greater frequency than that referred in published series. Nevertheless, it continues to be a rare entity. Due to absence of characteristic signs and symptoms, diagnosis is only made once these lesions have reached a size, sufficiently large to be palpable or when they cause compression on organs or neighboring structures. The cyst can present with chronic manifestations such as diffuse abdominal pain imprecisely located but associated with palpable mass, or due to complications of the cyst or due to compression of adjacent structures. Diagnosis is confirmed by imaging studies, such as the different ultrasound modalities, computed tomography (CT) scan, and magnetic resonance imaging (MRI). A differential diagnosis must be made to exclude other intra-abdominal or retro-peritoneal tumors. Optimum treatment is extirpation of the cyst. On occasion it is also necessary to remove the adjacent organ due to the impossibility of enucleating cyst. marsupialization of the cyst or drainage into peritoneal cavity, have high incidence of recurrence. Surgical treatment can be carried out by minimal invasion techniques.

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.

Malignant transformation of benign mesenteric cyst.

We describe the clinical and pathological features of a case of mesenteric cyst which was incompletely excised, recurred over several years, and eventually underwent malignant transformation. A review of the literature shows how mesenteric cysts are still poorly understood clinical entities, often difficult to classify even after histopathological evaluation. This is the first reported case of transformation of a benign mesenteric cyst into adenocarcinoma. Complete excision of all mesenteric cysts should be carried out, to prevent recurrence and possible malignant transformation.

[Mesenteric cyst]. / Cisto mesentérico.

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.

Mesenteric, omental, and retroperitoneal cysts in children: a clinical study of 22 cases.

Cystic lesions of the mesentery, omentum, and retroperitoneum are rare; from 1956 to 1990, 22 patients had operative treatment for such lesions at our institution. They ranged in age from 1 month to 14 years; 75% were younger than 5 years. All had either an acute abdomen or, more commonly, a silent abdominal mass. In all cases, the histologic diagnosis was lymphangioma. Abdominal ultrasonography was done in all cases after 1977 except for two patients who had an acute abdomen requiring emergency exploration. A cystic abdominal mass was diagnosed in 94% of these cases, but the correct diagnosis of lymphangioma was made prior to surgery in only 24%. Mesenteric cysts are most common in the small bowel mesentery. Omental cysts usually occur singly and are easily resected, but multiple cysts predominate in the mesentery and retroperitoneum. Complete resection was accomplished in 82% of our cases. Two patients required partial bowel resection, and four had partial excision with marsupialization of the cysts. With a mean follow-up of 23 months, we have had three recurrences, but none necessitated reexploration. Extra-abdominal lesions, mainly cutaneous lymphangiomas, developed in two cases. Prognosis is good after surgical excision, but long-term follow-up is advisable because of the possibility of recurrence, even during adulthood.

Chylous mesenteric and retroperitoneal cysts of developmental origin amongst Ethiopians: report of four cases.

Chylous mesenteric and retroperitoneal cysts of developmental origin are unusual and rarely diagnosed with accuracy before laparotomy. They may produce compression of viscera and may rupture with haemorrhage. This is the first report of four cases, with varied presentations, from an African country.

Mesenteric and omental cysts: an ultrasonographic and clinical study of 15 patients.

The clinical and ultrasonographic (US) features of 15 cases of mesenteric or omental cyst are herein described. This series included seven male and eight female patients, whose age ranged from 2-89 years. Correct clinical diagnosis was made in two children only, but preoperative US examination accurately demonstrated the lesion in 11 of 13 patients (85%). These cystic lesions usually had a thin wall, internal septations, and fluid content with sedimentation. Enteric duplication cysts had a relatively thick wall merging with the muscle layer of bowel loop, and multiloculation was noted mainly with cystic lymphangiomas or pseudocysts. The diagnostic and surgical management of these lesions are briefly reviewed and their US appearance is illustrated.

Mesenteric cysts in Nigerians.

Mesenteric cysts are uncommon and are said to be rarer among blacks than in caucasians. We report six mesenteric cysts seen in five patients over a 9 1/2 year period with an incidence of one in 48,497 hospital admissions. there were three males and two females. Ultrasonography was carried out in three of our five cases. There is need to include mesenteric cyst in the differential diagnosis of an abdominal mass. Surgery was the mainstay of treatment. At laparotomy, five of the cysts were found in the mesentery of the small bowel. Simple enucleation was done in one patient while cyst resection with adjacent bowel was carried out in three patients. There were two cysts in the youngest patient and these were internally drained. All the patients did well with uneventful post-operative period with no mortality. Follow up had been from 14 months to 6 years.

[Mesenteric cysts in Denmark in 1980-86]. / Mesenteriale cyster i Danmark 1980-86.

On the basis of a material of mesenteric cysts from a period of six years in all Denmark, the symptomatology, diagnosis and treatment of mesenteric cysts (MC) are described. These cysts are rare: approximately one par 130,000 somatic admissions. Mesenteric cysts may be encountered along the entire gastro-intestinal canal from the duodenum to the rectum but are, however, most frequent in the mesentery of the small intestine. The symptoms were variable and depended upon the site, mobility, tension on the mesentery, the complications and, to a lesser extent, on the size. Ultrasonic scanning was the most important diagnostic aid. 5% of the cysts contained chyle and up to one third of these are stated to be malignant. Computed tomographic scanning is recommended preoperative as the density can reveal whether the content is chylous. Enucleation of mesenteric cysts would be attempted but, in cases of large cysts which prove difficult to resect, internal marsupialization may be employed. Material with low frequencies of recurrence and few complications have been presented employing this therapeutic method.

Clinical Studies of Abdominal Tumors in Infants and Chi1dren: Ten Year Review

We have clinically observed 39 patients with abdominal tumors who were admitted in Severance Hospital during the past 10 years from April 1960 to March 1970. Unfortunately follow-up study couldn't be made. The following results were obtained. 1) Of the total number observed, 25 patients were male and 14 patients female. 2) The majority of the patients, 34 (87%) were under 6 years of age and 20 (51%) were between 1 to 3 years of age. The youngest patient was a 3-month-old female with Wilms' tumor. 3) In our series, Wilms' tumor (15 cases, 38.5%) was the most common and neuroblastoma (8 cases) was next most common tumor in the abdominal cavity. In addition we found another 4 cases of neuroblastoma in other sites. We observed hepatoma (8cases), ovarian tumor (3cases), lymphosarcoma (2cases), mesenteric cyst (one case) and adenoma of the left adrenal gland (one case) in that order of frequency. 4) In 15patients with Wilms' tumor, hypertension was observed in 8 patients and hematuria in 4 patients. Compared with Wilms' tumor, no hematuria was noted in the cases with neuroblastoma and hypertension occurred in 3 of these. 5) On abdominal X-ray, calcification was present in 4 cases with neuroblastoma (50%) and was present in only one of 15 patients with Wilms' tumor. 6) Comparing the sites of metastasis between Wilms' tumor and neuroblastoma, 4 of 15 patients with Wilms' tumor had lung metastasis and 4 of 8 patients of neuroblastoma had bony metastasis. Liver metastasis was found at autopsy in one case of neuroblastoma. 7) Three cases of hepatoblastoma were under 2 years of age and three cases of hepatocarcinoma were over 12 years of age. 8) Three cases of ovarian tumor were benign cystic teratoma. Tortion of the ovarian pedicle occurred in one of 3 patients with severe low abdominal pain. All patients were discharged in good condition after salphingo-oophorectomy. 9) One case of lymphosarcoma of the ileum was associated with intussusception. 10) A one year o1d female with adenoma of the left adrenal gland had typical Cushing's syndrome.