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Suldrup F, Uad P, Vaccaro A, Mazza M, Santino J, Mazza O. Mesenteric root pseudocyst: finding in an asymptomatic patient-a case report. Surg Case Rep 2024; 10:72. [PMID: 38548968 PMCID: PMC10978559 DOI: 10.1186/s40792-024-01830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/27/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Mesenteric cysts are one of the rarest abdominal tumor masses, representing a little-studied pathology. In turn, the variability and non-specificity of clinical manifestations make diagnosis difficult, as it can be reached by imaging findings due to another cause or by non-specific abdominal pain. CASE PRESENTATION This article describes the case report of an asymptomatic 28-year-old patient who presented a 6-cm abdominal cystic mass with mixed density, which was found incidentally by computed tomography. Exploratory laparoscopy was performed followed by conversion to conventional surgery to extract the tumor mass. The anatomical pathology diagnosis was pseudocyst of the mesentery root. Mesenteric cysts are one of the rarest abdominal tumor masses, representing a little-studied pathology. In turn, the variability and non-specificity of clinical manifestations make diagnosis difficult, as it can be reached by imaging findings due to another cause or by non-specific abdominal pain. CONCLUSIONS Mesenteric cysts are rare, and their nonspecific symptoms often lead to diagnosis based on imaging findings. Complete laparoscopic enucleation is the standard treatment.
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Affiliation(s)
- F Suldrup
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - P Uad
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - A Vaccaro
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - M Mazza
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - J Santino
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - O Mazza
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Hernandez Cervantes BY, Martinez Lopez D, Almaguer Acevedo FM, Betamcourt Benjamin M, Guzman Lambert R, Rodriguez Gonzalez M. Adult with concurrent mesenteric cyst and acute appendicitis: a case report. J Surg Case Rep 2023; 2023:rjad275. [PMID: 37220593 PMCID: PMC10200360 DOI: 10.1093/jscr/rjad275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/25/2023] [Indexed: 05/25/2023] Open
Abstract
Mesenteric cysts are uncommon intra-abdominal lesions that account for only one in every 100 000 adult hospitalizations. Their diagnosis is based on a comprehensive clinical examination as well as radiological modalities such as ultrasonography and computed tomography (CT) scans, and it is usually a clinical challenge because of non-specific symptoms. We present our first case of a 51-year-old man with a simple mesenteric cyst accompanying acute appendicitis diagnosed by CT scan of the abdomen and treated by exploratory laparotomy, complete enucleation of the cyst and appendectomy with a 10 month follow-up without complications or recurrence. This type of presentation has not been thoroughly investigated, with only two children reported during our literature review. Even if there is a high level of suspicion, a CT scan is required for confirmation.
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Affiliation(s)
- Barbara Y Hernandez Cervantes
- Correspondence address. Department of Surgery, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana. Tel: +233 549344585; E-mail: and
| | - Duniesky Martinez Lopez
- Department of Internal Medicine, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | | | | | - Radisnay Guzman Lambert
- Department of Surgery, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
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Mertens J, Driessen A, Komen N. An accidental finding of a giant intra-abdominal mass. Acta Chir Belg 2023; 123:85-89. [PMID: 33905308 DOI: 10.1080/00015458.2021.1920668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Mesenteric cysts are rare intra-abdominal tumours often found incidentally on imaging studies or during surgery. The clinical presentation is various with most subjects being asymptomatic, but complications can occur such as torsion, rupture, hemorrhage or obstruction of nearby structures. The etiology of mesenteric cysts remains uncertain. Complete surgical resection is preferred, although there are no specific guidelines concerning optimal treatment strategy. CASE REPORT We present a 61-year-old male with type 2 diabetes mellitus who underwent a routine abdominal ultrasound examination which accidentally uncovered a large mass. The patient had no complaints nor any physical discomfort. Magnetic resonance imaging and computed tomography revealed a giant thin-walled cyst with multiple septa spanning 24 × 24 cm2 originating from the mesentery. The primary differential diagnosis included a mesenteric cyst, a hydatid cyst due to echinococcus or malignancy. After multidisciplinary team approach, open surgical exploration was preferred. Surgical drainage and cyst sac resection were performed without any peri- or postoperative complications. Histopathology confirmed the presence of a large mesenteric cyst, probably caused post-traumatically. The patient has made a full recovery. CONCLUSION Mesenteric cysts can develop asymptomatically and reach enormous proportions. They are often found accidentally. Imaging studies aid in the differential diagnosis, but histopathology remains the diagnostic gold standard. Surgical resection prevails compared to a conservative approach due to the risk of complications. The choice between open or laparoscopic surgery should be determined based on the perioperative risk.
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Affiliation(s)
- Jonathan Mertens
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Antwerp, Belgium.,Laboratory of Experimental Medicine and Paediatrics (LEMP), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Ann Driessen
- Department of Pathology, Antwerp University Hospital, Antwerp, Belgium.,Core, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Niels Komen
- Department of Surgery, Antwerp University Hospital, Antwerp, Antwerp, Belgium.,Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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4
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A Rare Case of Calcified Simple Mesenteric Cyst in a 70-Year-Old Woman. Case Rep Surg 2022; 2022:8692421. [DOI: 10.1155/2022/8692421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
Mesenteric cysts are one of the rare causes of intra-abdominal masses. They account for 1 in 100,000 cases in adults and 1 in 20,000 cases in children. Mesenteric cysts are commonly found in the small intestine, up to 60% of cases, and occasionally in the colon. The clinical presentation of patients with mesenteric cysts is so variable and nonspecific. It ranges from being asymptomatic to features of acute abdomen very rarely. Surgery is the treatment of choice. Complete excision with negative margins plays a curative role in avoiding the risk of recurrence as well. Here, we present the case of a 70-year-old woman who came to Hawassa University Comprehensive Specialized Hospital with abdominal swelling for a 5-month duration. She had an abdominal ultrasound, which suggested a calcified mesenteric cyst with internal hemorrhage. The patient was taken to the OR with the impression of an intra-abdominal mass for exploratory laparotomy. The mass was completely excised and was subjected to pathology, which turned out to be a calcified simple mesenteric cyst, and the purpose of this case report is to alert physicians that although the preoperative diagnosis of mesenteric cysts is difficult, it should be considered in the differential diagnosis of a patient presenting with an intra-abdominal mass.
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Eke C, Greenberg I, Kedia P. Not Your Typical Cyst: A Periduodenal Chylous Cyst Diagnosed via Endoscopic Ultrasound. Cureus 2022; 14:e27284. [PMID: 36039205 PMCID: PMC9403218 DOI: 10.7759/cureus.27284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 11/17/2022] Open
Abstract
Chylous mesenteric cysts represent a subgroup of uncommon, mostly benign intra-abdominal masses often identified incidentally on radiographs. Diagnosis is often challenging because these lesions cannot be reliably distinguished from hematomas or other cystic lesions without direct tissue sampling. In addition, data remains scarce regarding nonsurgical diagnostic and therapeutic options for these cysts. This case describes an endoscopic option for a uniquely located chylous cyst.
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Aguilar-Espinosa F, Salcedo-Vargas R, Galván-Bizarro HA, Rodríguez-Ramos CR, Barba-Jaramillo ED. Mesenteric cyst manifested as obesity, gastroesophageal reflux, urinary incontinence, and abdominal mass during pregnancy-Case report and literature review. Int J Surg Case Rep 2022; 97:107366. [PMID: 35841759 PMCID: PMC9403017 DOI: 10.1016/j.ijscr.2022.107366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The mesenteric cyst (MC) is a rare entity, a benign lesion that causes the growth of an abdominal mass and other clinical presentations. The presentation of MC during pregnancy is even less frequent. CASE PRESENTATION A 34-year-old Mexican woman presented with a mesenteric cyst treated with laparotomy aspiration during the 16th week of pregnancy; the pregnancy was resolved by cesarean section without problems. Nevertheless, 17 months later, the lesion recurred. New assessment and surgical treatment with complete excision are performed without evidence of further recurrence. CLINICAL DISCUSSION This case is essential due to the low frequency of association between pregnancy and mesenteric cyst. Incomplete resection, aspiration, and marsupialization of the lesion carry a high risk of recurrence. Therefore, the opportune moment to perform a complete resection of the lesion and avoid complications should be evaluated during pregnancy. CONCLUSION MC should be considered a differential diagnosis in cystic lesions during pregnancy. Imaging studies, complete surgical resection, histological evaluation, and follow-up are necessary for adequate treatment.
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Affiliation(s)
- Francisco Aguilar-Espinosa
- General Surgery, General Hospital of Zone 21, Mexican Institute of Social Security, Tepatitlan de Morelos, Jalisco, Mexico.
| | - Rodolfo Salcedo-Vargas
- Pathological Anatomy, Santa Fe Memorial Hospital, Tepatitlan de Morelos, Jalisco, Mexico
| | - Hiram Alfonso Galván-Bizarro
- Medical Student, General Hospital of Zone 21, Mexican Institute of Social Security, Tepatitlan de Morelos, Jalisco, Mexico
| | - Carlos Rubén Rodríguez-Ramos
- Anesthesiology, General Hospital of Zone 21, Mexican Institute of Social Security, Tepatitlán de Morelos, Jalisco, Mexico
| | - Erika Diana Barba-Jaramillo
- General Surgery, General Hospital of Zone 21, Mexican Institute of Social Security, Tepatitlan de Morelos, Jalisco, Mexico
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Pai PK, Gudmundsdottir H, Hull NC, Thacker PG, Klinkner DB. Chylolymphatic mesenteric cyst with midgut volvulus in an adolescent: a peculiar presentation. Radiol Case Rep 2022; 17:420-422. [PMID: 34934468 PMCID: PMC8654696 DOI: 10.1016/j.radcr.2021.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/30/2021] [Indexed: 11/18/2022] Open
Abstract
Mesenteric cysts are rare intra-abdominal masses in the pediatric population, with the chylolymphatic variant comprising only 7.3% of all abdominal cysts. These cysts can have a varied clinical presentation, ranging from asymptomatic cystic masses to intestinal obstruction. We report a 16-year-old female, who presented with acute abdominal pain and vomiting, and was diagnosed with an intra-abdominal cystic mass with midgut volvulus accompanied by the classical "whirlpool sign" on imaging. She underwent laparoscopic abdominal exploration, which revealed a large chylolymphatic mesenteric cyst associated with feeder lymph vessels. This cyst had resulted in volvulus of the small bowel. The bowel was detorsed and found to be viable, and the cyst was removed en bloc after suction evacuation with ligation of the lymphatic feeder vessels. Midgut volvulus in the pediatric population is usually secondary to malrotation, but in this case the patient's small intestine was not found to be malrotated, and hence we present this case and urge physicians to consider a diagnosis of midgut volvulus even in the absence of malrotation in a child with a cystic abdominal mass presenting as intestinal obstruction.
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Affiliation(s)
- Priya K Pai
- Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905 USA
| | | | - Nathan C Hull
- Division of Pediatric Radiology, Mayo Clinic, Rochester, MN, USA
| | - Paul G Thacker
- Division of Pediatric Radiology, Mayo Clinic, Rochester, MN, USA
| | - Denise B Klinkner
- Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905 USA
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Tripathy PK, Jena PK, Pattnaik K. Management outcomes of mesenteric cysts in paediatric age group. Afr J Paediatr Surg 2022; 19:32-35. [PMID: 34916349 PMCID: PMC8759422 DOI: 10.4103/ajps.ajps_158_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Mesenteric cysts are rare intra-abdominal masses and high index of suspicion is required to clinically suspect this pathology and make a definitive diagnosis. They are most commonly located in the ileal mesentery but can be located anywhere along the gastrointestinal tract mesentery and may extend into the retroperitoneum. The rarity of these anomalies and diversity of clinical picture pose challenges in the diagnosis and operative management. The objective of this study is to determine the demographic pattern, clinicopathological diagnosis and management outcome of mesenteric cysts in our hospital. MATERIALS AND METHODS This retrospective study was conducted on children operated for mesenteric cysts from October 2013 to September 2020. Statistical analysis was performed using Open Epi Version 3.01. RESULTS Out of 32 children with a diagnosis of mesenteric cyst, 78% were below 5 years of age. Small intestine was affected in 26 cases and large bowel mesentery was the site of origin in six cases. Complete excision of mesenteric cyst was possible in all cases. Bowel resection was required in ten cases (31%) to enable complete excision. Bowel resection was required more often in children operated on emergency than those with elective surgery, and is statistically significant (P = 0.04; confidence interval: 0.05-0.96, odds ratio: 0.23). An uncommon co-existence with ileal atresia and detection of rare chylolymphatic cyst in another infant were also remarkable findings. Histopathology proved the diagnosis in all cases. There was no mortality or recurrence during hospitalisation and follow-up, which ranged from 3 months to 3 years. CONCLUSIONS Mesenteric cysts present with diverse clinical features and children below 5 years of age are most commonly affected. Complete surgical excision is the optimal treatment and may require bowel resection in significant number of cases, especially those operated during emergency. Histopathology is the gold standard for diagnosis.
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Affiliation(s)
| | - Pradeep Kumar Jena
- Department of Pediatric Surgery, SCB Medical College, Cuttack, Odisha, India
| | - Kaumudee Pattnaik
- Department of Pathology, SCB Medical College, Cuttack, Odisha, India
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Patil SS, Shah PB, Kudrimoti JK, Nakate LA. Bubbles in the belly- a case based approach to cystic peritoneal masses. SURGICAL AND EXPERIMENTAL PATHOLOGY 2021. [DOI: 10.1186/s42047-021-00099-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Primary cystic neoplasms of the peritoneum are rare lesions and not commonly encountered in practice. Many intra-abdominal processes may mimic cystic masses within the peritoneal cavity and pose a diagnostic challenge to both the pathologist and radiologist. Clinical presentation is diverse and varied. These lesions are usually benign. Hence complete surgical excision is the treatment of choice in most of the cases.
Methods
Study design: Descriptive Retrospective study.
Cystic peritoneal lesions were identified and studied from data over a period of 5 years in the Histopathology Section at a tertiary care hospital in Pune, India. Mode of presentation, imaging findings in addition to gross and histopathologic findings of these lesions were studied.
Results
Out of 50 peritoneal lesions studied over a period of 5 years, only 7 were identified to be cystic peritoneal masses.
Of these two were found to be peritoneal cysts, two mesenteric cysts, one an infected mesenteric cyst and one each a mucinous cystadenoma and lymphangioma.
Conclusions
Correct diagnosis rests in the hands of the pathologist and ensures that the patient receives appropriate and timely management. Hence knowledge of the spectrum of these rare cystic peritoneal masses is necessary to distinguish from other potential cystic abdominal mimicker masses and avoid a potential pitfall.
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10
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Lokavarapu MJ, Huda F, Mahindrakar B, Kumar S, Kumar N. Giant Mesenteric Cyst With Gastric Perforation Masquerading As Obstructed Inguinal Hernia: A Rarest of the Rare Case. Cureus 2021; 13:e17919. [PMID: 34660112 PMCID: PMC8515911 DOI: 10.7759/cureus.17919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/12/2022] Open
Abstract
Mesenteric cysts are extremely rare intra-abdominal tumors. They usually present with an array of symptoms, usually non-specific, which leads to difficulty in diagnosing them. Occasionally these can present in the emergency as an acute abdomen. We report a rare presentation of a huge mesenteric cyst with gastric perforation, misdiagnosed clinically as obstructed inguinal hernia. A 50-year male presented with complaints of sudden severe pain in the abdomen along with swelling and pain in the right groin region with absolute constipation for the last 4 days. A clinical diagnosis of obstructed inguinal hernia was made. However, on radiological investigations, it was discovered as a giant intra-abdominal cyst herniating into the inguinal canal. On exploration, we were further surprised to find a concomitant gastric perforation. In this case report, we highlight that mesenteric cysts can present as acute abdomen and, very rarely, can be associated with an accompanying cause of surgical abdomen.
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Affiliation(s)
| | - Farhanul Huda
- General Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | | | - Shashank Kumar
- General Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Navin Kumar
- General Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Ogwal A, Ariaka H, Medeyi V, Nkonge E, Oyania F. Management of a huge symptomatic hemorrhagic mesenteric cyst. Clin Case Rep 2020; 8:2986-2989. [PMID: 33363864 PMCID: PMC7752329 DOI: 10.1002/ccr3.3299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/21/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023] Open
Abstract
Mesenteric cysts are uncommon benign tumors with atypical clinical presentations. An acute presentation may not necessarily warrant emergency surgery, and planned surgery can achieve excellent results if the patient is hemodynamically stable at presentation.
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Affiliation(s)
| | | | | | | | - Felix Oyania
- Paediatric SurgeryMbarara National Referral HospitalMbararaUganda
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12
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Yavuz Y, Varman A, Şentürk ÜM, Kafadar MT. Mesenteric Cyst in 22 Cases. J Gastrointest Cancer 2020; 52:993-996. [PMID: 32970308 DOI: 10.1007/s12029-020-00522-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study is to retrospectively and multi-centerly examine the clinicopathological features of patients who were operated with the diagnosis of mesenteric cyst, which is a rare cause of intra-abdominal mass in the last 9 years, in the light of the literature. METHODS The patients were operated due to mesenteric cysts in the general surgery clinics of two Training and Research Hospital between 2010 and 2019; age, gender, preoperative clinical findings, computed tomography (CT) findings, localization of the mass, surgical procedure, morbidity, histopathological results, and follow-up period status were analyzed and reported electronically. RESULTS The patients generally applied with the complaints of abdominal pain, palpable abdominal mass, and abdominal distention. Fourteen (63.7%) of the cases were male and 8 (36.3%) were female. The mesenteric cysts were located in the small intestine in 18 cases and colon in 4 cases. In the histopathological examination of the surgical materials, simple cyst was detected in 17 cases, lymphangioma in 4 cases, colon adenocarcinoma, and simple cyst in 1 case. In the postoperative period, superficial surgical site infection developed in 3 patients and morbidity developed in 1 patient due to anastomotic leakage. CONCLUSION Although mesenteric cysts are rarely seen, although most of them are not histopathologically malignant, they can reach large sizes and require extensive surgical operation, and related morbidities can be seen. Therefore, mesenteric cysts should be followed carefully in the postoperative period as well as during the diagnosis and surgical treatment process.
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Affiliation(s)
- Yusuf Yavuz
- Clinic of General Surgery, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Alper Varman
- Clinic of General Surgery, Konya Provincial Health Directorate Dr. Ali Kemal Belviranli Obstetrics and Pediatrics Hospital, Konya, Turkey
| | - Üyesi Mustafa Şentürk
- General Surgery Department, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey.
| | - Mehmet Tolga Kafadar
- Clinic of General Surgery, Health Sciences University Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey
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Carvalho NMND, Lopes Filho JA, Plens ICM, Camara VA, Teixeira CCDG, Figueiredo PHD, Araujo Junior OND. Mesenteric cyst presenting with acute abdomen pain and bowel obstruction: Case report and brief literature review. Ann Med Surg (Lond) 2020; 58:134-137. [PMID: 32983433 PMCID: PMC7493041 DOI: 10.1016/j.amsu.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 02/03/2023] Open
Abstract
Mesenteric cysts were first described in 1507 and since then remain as a rare intraabdominal pathology. The etiology of this kind of tumor is still unclear and the classification remains controversial. They are usually asymptomatic, but can also cause acute abdominal pain and sometimes need emergency surgical approach. Clinical history, physical exam and complementary tests do not always provide diagnosis, which in many cases is made after surgery. Surgical management with complete excision of the cyst is the gold standard treatment. Laparoscopy technique should be preferred whenever is possible. The knowledge of these rare tumors is important for considering the correct approach. The goals of this article is to describe a case report of mesenteric cyst presented with acute abdominal pain at the emergency and do a brief literature review about this entity. Mesenteric cysts are a rare cause of intraabdominal mass. Mesenteric cyst should always be considered it whenever the patient has an intraabdominal palpable mass. Computed tomography of the abdomen can help find the diagnosis in many cases. Even when mesenteric cyst is diagnosed incidentally, surgery should always be indicated in order to prevent complications. Surgery is the treatment of choice and recurrence rate is low when the correct treatment is performed.
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The Lesser Sac and Foramen of Winslow: Anatomy, Embryology, and CT Appearance of Pathologic Processes. AJR Am J Roentgenol 2020; 215:843-851. [PMID: 32783559 DOI: 10.2214/ajr.19.22749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. This article reviews the embryologic development, relevant anatomy, and imaging features, on CT, of pathologic processes involving the lesser sac and foramen of Winslow. CONCLUSION. The lesser peritoneal sac is an intricate anatomic region involved in many disease processes. It is a significant conduit for the spread of disease within the peritoneal cavity. The spectrum of pathologic processes pertaining to the lesser sac can be classified on the basis of the type of involvement, such as a fluid collection (e.g., transudate, exudate, bile, and blood), a mass (e.g., neoplastic or nonneoplastic conditions and lymphadenopathy), or an internal hernia into the lesser sac.
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15
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Raj N, Bagalkot VS. Case Report: a Case of Jejunal Mesenteric Teratoma in Adult Male: a Rare Case. Indian J Surg Oncol 2020; 11:193-195. [PMID: 33364696 DOI: 10.1007/s13193-020-01122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/02/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nischal Raj
- Departmnet of General Surgery, MMC & RI, Mysuru, India
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16
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Rauh JL, Miller-Ocuin JL, Gaffley M, Hildreth AN. Emergency Surgical Management of a Ruptured Mesenteric Cyst. Am Surg 2020. [DOI: 10.1177/000313482008600306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jessica L. Rauh
- Department of Surgery Wake Forest Baptist Health Winston Salem, North Carolina
| | | | - Michaela Gaffley
- Department of Surgery Wake Forest Baptist Health Winston Salem, North Carolina
| | - Amy N. Hildreth
- Department of Surgery Wake Forest Baptist Health Winston Salem, North Carolina
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17
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Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature. Case Rep Surg 2020; 2020:8932017. [PMID: 32082690 PMCID: PMC7008304 DOI: 10.1155/2020/8932017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/22/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction. Omental cysts are a part of cystic lymphangiomas and are benign proliferations of ectopic lymphatics without a communication with the normal lymphatic system. They commonly involve the neck in the pediatric population and are uncommon at other sites and occur rarely in adults. Case Presentation. A 42-year-old female with complaints of vague lower abdominal pain for 8 months presented with a soft, nontender swelling of size 22 × 18 cm in the hypogastrium and umbilical region. Computerized tomography (CT) of the abdomen showed a peripherally enhancing hypodense cystic lesion of size 19 × 14 × 12 cm perhaps arising from the mesentery. The cyst had spontaneously reduced in size by about 70% over the next 4 months. During surgery, the cyst of size 10 × 9 × 8 cm was present in the greater omentum. Excision was done, and histopathology was suggestive of cystic lymphangioma. Discussion. Cystic lymphangiomas have an incidence of 1/20000 at infancy and 1/100000 to 1/250000 of hospital admissions in adults, and the female-to-male ratio is 2 : 1. In adults, they are found in the age group between 40 and 70 years. Spontaneous regression of omental cysts is very rare and presumably from increased pressure in cysts overcoming incomplete obstructions or by establishment of alternative routes of drainage.
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18
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Sag S, Okatan BK, Metin N. A Rare Cause of Acute Abdomen in A Child: Infected Mesenteric Cyst. DICLE MEDICAL JOURNAL 2019. [DOI: 10.5798/dicletip.661423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Serena T, Gao R, Dinnan K. Open surgical approach for infected mesenteric pseudocyst presenting as lifelong, migratory abdominal pain-A case report. Int J Surg Case Rep 2019; 66:96-100. [PMID: 31821982 PMCID: PMC6906687 DOI: 10.1016/j.ijscr.2019.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Mesenteric psuedocysts are rare tumors of the gastrointestinal mesentery that are seldom symptomatic. Although these benign tumors are most commonly found incidentally during work-up for other pathology, they can be troublesome in select patients based off size, location and risk of malignant transformation. This case is reported in accordance with SCARE Criteria [1]. PRESENTATION OF CASE A 24 year-old-male presents with life-long migratory abdominal pain presents with a one week history of acute pain associated with nausea. Computed tomography revealed free fluid in the pelvis and a thin-walled mesenteric cyst within the left, mid-abdominal mesentery measuring approximately 4.3 × 4.0 × 4.0 cm. The patient was admitted for resuscitation and planned delayed operative intervention. DISCUSSION The patient underwent complete open enucleation secondary to location and in an attempt to limit injuries to or resection of small bowel. Pathological analysis revealed a mesenteric cyst with fluid culture positive for Propionibacterium acnes without true cystic wall consistent with an infected mesenteric pseudocyst. These lesions are difficult to diagnose secondary to varied presentation and lack of pathognomonic clinical, laboratory and imaging findings. Mesenteric pseudocyst have a low rate of recurrence after removal; however, surgical management is mandated due to risks of malignant transformation. CONCLUSION This is a rare case of a mesenteric pseudocyst of small size presenting with lifelong abdominal pain secondary to its location near the root of the mesentery and inflammatory reaction secondary to infection. It is important to maintain a high index of suspicion for mesenteric cyst as many complications may result if misdiagnosed or without proper surgical management.
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Affiliation(s)
- Thomas Serena
- Beaumont Health Farmington Hills, Department of General Surgery, 28050 Grand River Avenue, Farmington Hills, MI, 48336, USA.
| | - Raisa Gao
- Beaumont Health Farmington Hills, Department of General Surgery, 28050 Grand River Avenue, Farmington Hills, MI, 48336, USA.
| | - Kelly Dinnan
- Beaumont Health Farmington Hills, Department of General Surgery, 28050 Grand River Avenue, Farmington Hills, MI, 48336, USA.
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Dalla Pria HR, Torres US, Velloni F, Santiago RA, Zacarias MS, Silva LF, Tamamoto F, Walsh D, von Atzingen AC, Coffey JC, D'Ippolito G. The Mesenteric Organ: New Anatomical Concepts and an Imaging-based Review on Its Diseases. Semin Ultrasound CT MR 2019; 40:515-532. [DOI: 10.1053/j.sult.2019.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sima RM, Radosa JC, Zamfir R, Ionescu CA, Carp D, Iordache II, Stănescu AD, Pleş L. Novel diagnosis of mesenteric endometrioma: Case report. Medicine (Baltimore) 2019; 98:e16432. [PMID: 31335696 PMCID: PMC6709129 DOI: 10.1097/md.0000000000016432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Mesenteric cysts are benign gastrointestinal cystic lesions, with an incidence of <1/100 000. They usually develop in the small bowel mesentery, mesocolon (24%), retroperitoneum (14.5%), and very rarely originate from the sigmoid mesentery. Endometriomas represent a localized type of endometriosis and are usually within the ovary. Our case is unique because there are no reports in the literature of endometrial mesenteric cysts. PATIENT CONCERNS We present a case of a 29-year-old woman who underwent a routine gynecologic control. DIAGNOSIS Clinical examination and imaging identified 2 endometriomas on the left and posterior to the uterus. INTERVENTIONS The patient underwent exploratory laparoscopy. Unexpectedly, a 10 cm mesenteric cyst was identified; this was associated with adhesions in the left adnexal area and a left ovarian endometrioma. The classic surgical approach which was necessary identified the mesenteric cyst with cranial mesosigmoid and ileal adhesions, as well as distal adhesions which included the uterus, ileum, left ovarian endometrioma, left hydrosalpinx, left ureter, and rectum. The cyst was removed completely and a left adnexectomy was performed because of the presence of the endometrioma and adhesions. OUTCOMES The patient's outcome was favorable, with discharge at 72 hours after surgery. The histopathological report revealed that both the mesenteric and ovarian cysts were endometriomas. LESSONS Our case is unusual in that a mesenteric cyst was identified in a patient with no clinical symptoms. Furthermore, the histopathological examination revealed the endometriotic origin of the mesenteric cyst which has not previously been reported in the literature.
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Affiliation(s)
- Romina-Marina Sima
- Department of Obstetrics Gynecology, Carol Davila University of Medicine and Pharmacy
- St. John Hospital, “Bucur ”, Maternity, Bucharest, Romania
| | - Julia Caroline Radosa
- Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany
| | - Radu Zamfir
- Fundeni Clinical Institute, Dan Setlacec Department of General Surgery and Liver Transplant
| | - Cringu-Antoniu Ionescu
- Department of Obstetrics Gynecology, Carol Davila University of Medicine and Pharmacy
- Department of Obstetrics and Gynecology, Sf Pantelimon Clinical Emergency Hospital, Bucharest, Romania
| | - Delia Carp
- St. John Hospital, “Bucur ”, Maternity, Bucharest, Romania
| | - Ioan-Iulian Iordache
- Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany
| | - Anca-Daniela Stănescu
- Department of Obstetrics Gynecology, Carol Davila University of Medicine and Pharmacy
- St. John Hospital, “Bucur ”, Maternity, Bucharest, Romania
| | - Liana Pleş
- Department of Obstetrics Gynecology, Carol Davila University of Medicine and Pharmacy
- St. John Hospital, “Bucur ”, Maternity, Bucharest, Romania
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22
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Bang GA, Tolefac P, Fola O, Biyouma M, Bisay U, Guifo ML, Essomba A. Giant sixteen kilogram lymphangioma mesenteric cyst: An unusual presentation of a rare benign tumour. Int J Surg Case Rep 2019; 59:94-96. [PMID: 31125789 PMCID: PMC6531822 DOI: 10.1016/j.ijscr.2019.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/05/2019] [Indexed: 11/30/2022] Open
Abstract
Mesenteric cysts may present as giant abdominal masses. It is the heaviest (16 kg) mesenteric cyst reported in the literature to date. In low incomes countries, the interval between the onset of symptoms and consultation is often significant, leading to unusual presentations.
Background Mesenteric cysts are rare abdominal benign tumours with an incidence of 1:100.000–250.000 surgical admissions located in the mesentery. Theirs presentations may range from incidental asymptomatic discovery during imaging to non-specific abdominal symptoms. Case presentation We present the case of a 46 year old female who presented with 9 months history of progressive abdominal distension. CT scan showed a giant abdominal mass. After the necessary preoperative work up, a midline incision laparotomy was performed. Intraoperative findings were a mesenteric cyst originates from the transverse mesocolon. The cyst weighed 16 kg and histopathology analyses confirmed a lymphangioma mesenteric cyst. Discussion In low incomes countries like our own, the interval between the onset of symptoms and consultation is often significant, leading to unusual and sometimes spectacular presentations at the time of diagnosis. To our knowledge, it is the heaviest mesenteric cyst reported in the literature to date. Conclusion Mesenteric cysts may present as giant abdominal masses. The publication of this atypical case is a plea for us for the establishment of universal health coverage in our country in particular and in Africa in general.
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Affiliation(s)
- Guy Aristide Bang
- Department of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon.
| | - Paul Tolefac
- Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Olivier Fola
- Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Marcella Biyouma
- Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Ulrich Bisay
- Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Marc Leroy Guifo
- Department of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Arthur Essomba
- Department of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Surgical Unit, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
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23
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Aguirre SV, Mercedes Almagro M, Romero CA, Romero SS, Molina GA, Buenaño RA. Giant mesenteric cyst from the small bowel mesentery in a young adult patient. J Surg Case Rep 2019; 2019:rjz002. [PMID: 30697414 PMCID: PMC6344927 DOI: 10.1093/jscr/rjz002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/03/2018] [Accepted: 01/05/2019] [Indexed: 11/26/2022] Open
Abstract
Mesenteric cysts are rare tumors, they can emerge from any part of the mesentery of the bowel from the duodenum to the rectum. Their symptomatology can mimic almost any abdominal disease making diagnosis troublesome. In some circumstances, these cysts can grow to considerable sizes making resection almost impossible since its size can compromise different structures. Surgery is the treatment of choice as complete resection is the only curative treatment. We present a case of a female patient, she suffered from recurrent episodes of abdominal pain mistaken as gastritis. After a profound evaluation, a giant mass in her abdomen was identified and successfully treated. Giant primary mesenteric cyst was the final diagnosis.
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Affiliation(s)
- S Vicente Aguirre
- Department of General Surgery, Hospital Eugenio Espejo, Quito, Ecuador
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24
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Wall KC, Schmitz R, Carney JM, Blazer Iii DG. Large mesenteric lymphangioma in an adult patient: an unusual presentation of a rare disease. BMJ Case Rep 2018; 2018:bcr-2018-226319. [PMID: 30297495 DOI: 10.1136/bcr-2018-226319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Lymphangiomas are most commonly described as a small painless mass in the neck or a vesicular rash in an infant patient. Ninety per cent of cases are diagnosed before the age of 2. Treatment usually involves surgical resection. Intra-abdominal lymphangiomas and mesenteric lymphangiomas, as described in our case report, represent a rare pathology. The exact prevalence of this condition is unclear but it has been suggested in the literature that there have been as few as 820 cases since the 16th century. The clinical presentation is usually subacute and diagnosis made incidentally during a workup of chronic gastrointestinal symptoms. Acute abdominal symptoms, as in our case presentation, are unusual but may be explained by the mass effect of a large intra-abdominal lesion. Cross-sectional imaging is key in preoperative workup and operative planning. Complete surgical resection is recommended and curative in the majority of cases with a low risk of local recurrence.
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Affiliation(s)
- Kevin C Wall
- Duke University School of Medicine, Duke University Health System, Durham, North Carolina, USA
| | - Robin Schmitz
- Department of Surgery, Duke University Hospital, Durham, North Carolina, USA
| | - John M Carney
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Dan G Blazer Iii
- Department of Surgery, Duke University Hospital, Durham, North Carolina, USA
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25
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Jan H, Kapoor T, Ghai V. A Stepwise Approach to Laparoscopic Enucleation and Excision of Retroperitoneal Cysts. J Minim Invasive Gynecol 2018; 26:367-368. [PMID: 29783002 DOI: 10.1016/j.jmig.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/26/2018] [Accepted: 05/12/2018] [Indexed: 10/16/2022]
Abstract
STUDY OBJECTIVE To show a step-by-step approach to laparoscopic enucleation and excision of retroperitoneal cysts using a technical video. DESIGN A technical video (Canadian Task Force classification III). SETTING A benign gynecology department at a university hospital. INTERVENTION Laparoscopic enucleation and excision of retroperitoneal cysts. CONCLUSION Retroperitoneal cysts are rare lesions associated with numerous complications including compression on neighboring organs, infection, rupture, and malignant transformation. Excision of retroperitoneal cysts can be challenging, and dissection of the retroperitoneal space is associated with bowel and vascular injury [1]. Laparoscopic drainage and fenestration have been promoted to prevent visceral injury [2]. Such approaches are ineffective, with increased recurrences and fluid accumulation requiring repeat surgical procedures [3,4]. Successful laparoscopic excision of retroperitoneal cysts has been reported although there are no published videos of the technique [5]. In this video, we use 2 separate cases to show our step-by-step laparoscopic approach to enucleate and excise retroperitoneal cysts. Various methods to safely enter retroperitoneal spaces to avoid inadvertent damage to surrounding structures are detailed. A combination of careful blunt and sharp dissection is used to find specific planes to separate the cyst from the overlying peritoneum and underlying pelvic sidewall structures such as the ureter, vasculature, and nerves. We minimize energy use, and, when it is used, we are mindful regarding active blade positioning of the ultrasonic dissector to prevent inadvertent cyst rupture and injury to the surrounding structures. Keeping the cysts intact aids in leverage and prevents inadvertent spillage of potentially malignant contents. The cysts are retrieved laparoscopically by contained bag decompression.
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Affiliation(s)
- Haider Jan
- Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom
| | - Tina Kapoor
- Department of Obstetrics and Gynaecology, Worthing Hospital, West Sussex, United Kingdom
| | - Vishalli Ghai
- Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom.
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26
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Vallejo-Soto M, Orozco-Simental S. A giant mesenteric cyst mimicking untreatable ascites. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2017. [DOI: 10.1016/j.rgmxen.2017.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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27
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Vallejo-Soto M, Orozco-Simental S. A giant mesenteric cyst mimicking untreatable ascites. REVISTA DE GASTROENTEROLOGIA DE MEXICO 2017; 82:348-351. [PMID: 28215472 DOI: 10.1016/j.rgmx.2016.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/30/2016] [Accepted: 04/21/2016] [Indexed: 06/06/2023]
Affiliation(s)
- M Vallejo-Soto
- Servicio de Cirugía General, Hospital Ángeles y Star Médica de Querétaro, Querétaro, México.
| | - S Orozco-Simental
- Clínica de Diagnóstico Servicios Integrados de Imagenología, Querétaro, Querétaro, México
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28
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Giannos A, Stavrou S, Goumalatsos N, Fragkoulidis G, Chra E, Argiropoulos D, Loutradis D, Drakakis P. Mesenteric cysts and mesenteric venous thrombosis leading to intestinal necrosis in pregnancy managed with laparotomy: a case report and review of the literature. J Med Case Rep 2017; 11:184. [PMID: 28683785 PMCID: PMC5501070 DOI: 10.1186/s13256-017-1320-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/12/2017] [Indexed: 11/10/2022] Open
Abstract
Background Mesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation. Case presentation A 27-year-old Greek woman, gravida 2 para 1, presented at 10 weeks’ gestation to the Emergency Unit of our hospital complaining of diffuse abdominal pain which deteriorated the last 3 days, which was localized in her right iliac fossa, along with vomiting. She had undergone open laparotomy and right salpingo-oophorectomy at the age of 23 due to an ovarian cyst. Besides this, her personal and family medical history was unremarkable. She had never received oral contraceptives or any hormone therapy. On arrival, a clinical examination revealed tenderness on palpation of her right iliac fossa, without rebound tenderness or muscle guarding. Within 10 hours of hospitalization, her symptoms deteriorated further with rebound tenderness during the examination, tachycardia, and a drop of 12 units in her hematocrit value. An emergency laparotomy was performed. Two mesenteric cysts and a 60 cm necrotic part of her intestine were revealed intraoperatively. In the postoperative period, she complained of acute abdominal pain, tachycardia, and dyspnea. Computed tomography imaging revealed mesenteric vein thrombosis and pulmonary thromboembolism. She was treated with low molecular weight heparin and she was discharged on the 11th postoperative day. Conclusions To the best of our knowledge, this is the first report in the literature of a simultaneous mesenteric cyst and mesenteric vein thrombosis in pregnancy. It is known that pregnancy is a state of hypercoagulation and clinicians should bear in mind this rare clinical condition in their diagnostic algorithm for acute abdominal pain.
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Affiliation(s)
- Aris Giannos
- 1st OB/GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528, Athens, Greece.
| | - Sofoklis Stavrou
- 1st OB/GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528, Athens, Greece
| | - Nikolaos Goumalatsos
- 1st OB/GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528, Athens, Greece
| | - George Fragkoulidis
- 2nd Department of Surgery, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Chra
- Department of Pathology, Alexandra Hospital, Athens, Greece
| | | | - Dimitrios Loutradis
- 1st OB/GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528, Athens, Greece
| | - Peter Drakakis
- 1st OB/GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528, Athens, Greece
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29
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Belhassen S, Meriem B, Rachida L, Nahla K, Saida H, Imed K, Sana M, Amine K, Lassad S, Mongi M, Mohsen B, Abdellatif N. Mesenteric cyst in infancy: presentation and management. Pan Afr Med J 2017; 26:191. [PMID: 28674584 PMCID: PMC5483360 DOI: 10.11604/pamj.2017.26.191.11476] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/02/2017] [Indexed: 11/11/2022] Open
Abstract
Mesenteric cysts are documented as a rare entity in pediatric population. They are considered as benign intra-abdominal tumors with an unknown etiology. Symptoms are not specific and knowledge of such condition is essential in order to establish a proper management. We report three pediatrics cases of mesenteric cysts managed between 2000 and 2009 in the pediatric surgery Department of Monastir College Hospital. We described the clinical, radiological and operative findings. Two males and a female were managed (age range: 10 days-5years, mean age: 6,3years). Two patients were presented with an intestinal obstruction. A preoperative diagnosis was made basing on imaging. Thus, abdominal ultrasonography was performed in all of our reported cases and showed a cystic mass in all cases. The cystic nature of the mass, its margins and its extension were better described on tomographic images. The mesenteric cyst was completely and successfully removed in all cases. The histopathological report confirmed the diagnosis and showed a multiloculated cyst with columnar mesothelial lining, without any defined muscular layer or cellular atypia and without any evidence of malignancy. The children were evaluated post-operatively with a mean follow-up of 2 years and a half. No recurrence was noted in our patients during the follow-up period. It is known that clinical features are not specific of such anomaly but once the diagnosis is made, the complete surgical removal of the cyst remains the treatment of choice with excellent outcomes.
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Affiliation(s)
- Samia Belhassen
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Braiki Meriem
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia
| | - Laamiri Rachida
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Kechiche Nahla
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia
| | - Hidouri Saida
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Krichen Imed
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Mosbahi Sana
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Ksiaa Amine
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Sahnoun Lassad
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Mekki Mongi
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Belguith Mohsen
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
| | - Nouri Abdellatif
- University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.,Research Laboratory LR 12SP13, School of Medicine of Monastir University of Monastir, Tunisia
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Neeralagi CS, Surag KR, Kumar Y, Lakkanna S, Raj P. Mesenteric Teratoma in Elderly Female: A Rare Case Report. J Clin Diagn Res 2017; 11:PD01-PD02. [PMID: 28274002 DOI: 10.7860/jcdr/2017/23549.9268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 11/21/2016] [Indexed: 11/24/2022]
Abstract
Dermoid cysts rarely present as mesenteric cysts. Mesenteric cysts are rare pathologic entities, with a reported incidence of approximately 1 of 27 000 to 1 of 100 000 admissions. Mesenteric cyst was first described by Florentine anatomist Benevieni in 1507, while performing an autopsy on an eight-year-old boy. Most commonly, teratoma occurs in the early age group. Mature mesenteric teratoma in adulthood is extremely rare. Teratoma are germ cell tumours commonly composed of multiple cell types derived from one or more of the 3 germ layers. We present the case of a 69-year-old elderly female who presented with abdomen pain for nine months with right lumbar and right iliac fossa mass. Computed Tomography (CT) abdomen revealed bilocular cystic lesion with possibility of mucinous cystadenoma with no definitive organ of origin. She underwent explorative laparotomy and total excision of the cystic mass. Histopathologic examination confirmed diagnosis of mature cystic teratoma of mesentery. This case report highlights the need to maintain high index of suspicion while evaluating abdominal mass.
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Affiliation(s)
| | - K R Surag
- Junior Resident, Department of General Surgery, ESIC Medical College , Bengaluru, Karnataka, India
| | - Yogesh Kumar
- Junior Resident, Department of General Surgery, ESIC Medical College , Bengaluru, Karnataka, India
| | - S Lakkanna
- Professor, Department of General Surgery, ESIC Medical College , Bengaluru, Karnataka, India
| | - Preetham Raj
- Assistant Professor, Department of General Surgery, ESIC Medical College , Bengaluru, Karnataka, India
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31
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Ünlüer EE, Ünlüer S, Şahı N Y, Kamer KEN, Karagöz A, Tan GC. An uncommon cause of abdominal pain: Mesenteric cyst. Interv Med Appl Sci 2016; 8:23-25. [PMID: 28250978 DOI: 10.1556/1646.8.2016.1.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mesenteric cysts are benign cystic lesions. Here, we present the case of a patient with abdominal pain, which was diagnosed as mesenteric cyst. A 28-year-old male patient was admitted to the emergency department (ED) with abdominal pain and distention. Abdominal palpation revealed a smooth-surfaced mass palpable in the left upper quadrant. Ultrasonography depicted a hypoechoic heterogeneous mass-like structure with a size of 15 × 12 cm. Computerized tomography (CT) showed a well-defined cystic structure with a size of 12 × 12.5 cm near to the duodenum and pancreas. The patient was admitted, and the cystic structure was drained with a percutaneous drainage catheter; then, sclerotherapy was performed using ethyl alcohol with the aid of ultrasonography. The material was sent to the pathology lab and revealed negative results for malignant cell and mucin. The patient underwent a control CT with contrast, which revealed the catheter at the site of the operation and no cystic lesion after procedure. He was discharged 1 week after the procedure. Mesenteric cysts are extremely rare benign lesions of the abdomen, and emergency physicians must consider this disease in the differential diagnosis of abdominal pain. The percutaneous drainage technique performed on our patient is a safe technique for the treatment of selected patients.
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Affiliation(s)
- Erden Erol Ünlüer
- Emergency Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital , İzmir , Turkey
| | - Seran Ünlüer
- Cardiology Department, İzmir Buca Seyfi Demirsoy State Hospital , İzmir , Turkey
| | - Yusuf Şahı N
- Emergency Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital , İzmir , Turkey
| | - Kemal Erdı Nç Kamer
- General Surgery Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital , Izmir , Turkey
| | - Arıf Karagöz
- Emergency Department, İzmir Karşıyaka State Hospital , İzmir , Turkey
| | - Gözde Canan Tan
- Emergency Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital , İzmir , Turkey
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32
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Kumar A, Jakhmola C, Arora N, Chauhan S. Mesenteric cyst in sigmoid mesocolon - A rare location and its laparoscopic excision. Med J Armed Forces India 2015; 71:S425-8. [PMID: 26858476 PMCID: PMC4705198 DOI: 10.1016/j.mjafi.2014.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/13/2014] [Indexed: 02/07/2023] Open
Affiliation(s)
- Ameet Kumar
- Assistant Professor (Surgery), Army College of Medical Sciences and Classified Specialist (Surgery) and GI Surgeon, Base Hospital, New Delhi 10, India
- Corresponding author. Tel.: +91 9717072931 (mobile).
| | - C.K. Jakhmola
- Professor and Head (Surgery), Army College of Medical Sciences and Consultant (Surgery) and GI Surgery, Base Hospital, New Delhi 10, India
| | - N.C. Arora
- Consultant (Surgery and Orthopaedic Surgery) and Commandant, Base Hospital, New Delhi 10, India
| | - S.S. Chauhan
- Professor (Surgery), Army College of Medical Sciences and Classified Specialist (Surgery) and GI Surgeon, Base Hospital, New Delhi 10, India
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Abstract
The authors report a rare case of mesenteric monodermal teratoma that mimicked an ovarian tumor and was successfully managed with hand-assisted laparoscopic intervention. Mature cystic teratomas are benign neoplasms of germ cell tumors that occur most frequently in gonadal sites. The tumors usually contain 2 or 3 well-differentiated elements of endodermal, ectodermal, and mesodermal origin. Although relatively uncommon, teratomas can be composed of mature tissue originating from only 1 germ cell layer. This is known as a monodermal teratoma. Extragonadal teratomas, especially mesenteric teratomas, are extremely rare. Currently, only 21 cases of mesenteric teratoma have been described in the English literature. Mesenteric teratomas are rarely diagnosed preoperatively because pathological examination is necessary to make a definitive diagnosis. We herein report a rare case of mesenteric monodermal teratoma and review the literature. To the best of our knowledge, this is the first case of mesenteric teratoma treated with hand-assisted laparoscopic surgery.
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Affiliation(s)
- Yusuke Tanaka
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai, Osaka 5918025, Japan.
| | - Shinsuke Koyama
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan
| | - Yasuhiko Shiki
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan
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34
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Raherinantenaina F, Andriamampionona TF, Raoelijaona L, Randrianirina H, Mamin'ny Aina Rajaonanahary T, Nirina Rakoto Ratsimba H. [Cystic lymphangioma of the ascending mesocolon]. Presse Med 2014; 43:1296-8. [PMID: 24935682 DOI: 10.1016/j.lpm.2014.02.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 01/25/2014] [Accepted: 02/17/2014] [Indexed: 11/18/2022] Open
Affiliation(s)
- Fanomezantsoa Raherinantenaina
- Centre hospitalier universitaire Joseph-Ravoahangy-Andrianavalona (CHUJRA), service de chirurgie générale et vasculaire, BP 4150, Antananarivo, Madagascar.
| | | | | | - Hery Randrianirina
- CHUJRA, service de réanimation chirurgicale, BP 4150, Antananarivo, Madagascar
| | - Toky Mamin'ny Aina Rajaonanahary
- Centre hospitalier universitaire Joseph-Ravoahangy-Andrianavalona (CHUJRA), service de chirurgie générale et vasculaire, BP 4150, Antananarivo, Madagascar
| | - Hery Nirina Rakoto Ratsimba
- Centre hospitalier universitaire Joseph-Ravoahangy-Andrianavalona (CHUJRA), service de chirurgie générale et vasculaire, BP 4150, Antananarivo, Madagascar
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35
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Al Booq Y, Hussain SS, Elmy M. Giant chylolymphatic mesenteric cyst and its successful enucleation: A case report. Int J Surg Case Rep 2014; 5:469-70. [PMID: 24976602 PMCID: PMC4147644 DOI: 10.1016/j.ijscr.2014.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/01/2014] [Accepted: 05/15/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Cysts of the mesentery are among surgical rarities. The clinical presentation is not characteristic and in addition, the preoperative imaging although suggestive is not diagnostic in this case ultrasound and CTscan was consistent with giant mesenteric cyst. In most cases, the diagnosis is confirmed after surgical exploration. PRESENTATION OF CASE A 42 yrs old male patient on exploratory laparotomy had a 14cm×10cm×10 cm cysts which was seen arising from the mesentery ofdistal jejunum 80cm from the duodeno jejunal flexure. The cyst was enucleated successfully from themesentery without entailing resection. The cyst contained milky white fluid consistent with a chylolymphatic cyst. The diagnosis was confirmed on histopathology which revealed a cyst wall with lymphoidaggregates. After 3 years of follow-up, the patient is doing well and there is no evidence of recurrence. DISCUSSION The cysts may be asymptomatic or maymanifest with abdominal pain, distension lump or intestinal obstruction. Our patient was symptomatic with mild and long standing abdominal pain. The definitive diagnosis of these lesions is difficult prior to surgical exploration as there are no pathognomonic symptoms or characteristic imaging findings. CONCLUSION Cysts of the mesentery are among surgical rarities. In most of the cases the diagnosis is confirmed after surgical exploration and removal of thecyst. We would like to emphasize the importance of successful enucleation of the cyst irrespective of its size due to its independent blood supply as opposed to enterogenous cyst which requires bowel resection and anastomosis.
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Affiliation(s)
- Yousuf Al Booq
- Surgery Royal Commission Medical Center, Yanbu Al Sinayah, Saudi Arabia.
| | - Syed S Hussain
- Surgery Royal Commission Medical Center, Yanbu Al Sinayah, Saudi Arabia.
| | - Mohamed Elmy
- Surgery Royal Commission Medical Center, Yanbu Al Sinayah, Saudi Arabia
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36
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Reis DGD, Rabelo NN, Aratake SJ. Mesenteric cyst: abdominal lymphangioma. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2014; 27:160-1. [PMID: 25004298 PMCID: PMC4678677 DOI: 10.1590/s0102-67202014000200016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 11/23/2013] [Indexed: 11/22/2022]
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37
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Rare case report: mesocolonic dermoid cyst. Indian J Surg 2014; 75:116-7. [PMID: 24426534 DOI: 10.1007/s12262-012-0508-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 04/14/2012] [Indexed: 10/28/2022] Open
Abstract
Mesenteric cysts are one of the most rare intra-abdominal tumours [1], classified as chylolymphatic, mesothelial (simple), enterogenous, urogenital remnant, dermoid cyst (teratomatous), gas, mycotic, parasitic, tubercular cysts and cysts following malignant degeneration [2]. Dermoid cysts are uncommon mesenteric cysts [3]. Cysts of the mesocolon are rare and usually differentiated from a mesenteric cyst only at the operation [4]. We here report a rare case of a dermoid cyst that was present in the mesentery of the transverse colon.
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38
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Chylous mesenteric cyst: A diagnostic dilemma. Asian J Surg 2013; 39:182-6. [PMID: 23769746 DOI: 10.1016/j.asjsur.2013.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/23/2012] [Accepted: 04/15/2013] [Indexed: 11/21/2022] Open
Abstract
A mesenteric cyst is defined as a cyst that is located in the mesentery of the gastrointestinal tract and may extend from the base of the mesentery into the retroperitoneum. A case report of a patient with mesenteric cyst is presented. In addition, a systematic review was performed of English language literature on chylous mesenteric cysts in adult humans. Of the 18 articles included in the review, there were 19 cases of chylous mesenteric cysts reported. Male to female ratio was 1.4:1 with a median age of 46 years. A preoperative diagnosis of mesenteric cyst was made in four patients based on computed tomography. All patients underwent surgery and there were no reports of recurrence on follow up. Chylous mesenteric cyst is a rare entity that needs to be recognized whenever a preliminary diagnosis of intra-abdominal cystic mass is made.
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39
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Abstract
Mesenteric cyst is a rare condition. Presentation with non-typhoid 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. However, there are difficulties in diagnosis when it is present in an uncommon area and rare known complications. Mesenteric cyst can present with few uncommon emergency conditions which pose difficulties in diagnosis as well as treatment options as mentioned in this case.
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Affiliation(s)
- G Ramesh Reddy
- Department of General Surgery, Videhi Institute of Medical Sciences, Bangalore, Karnataka, India
| | - Shankar Gunadal
- Department of General Surgery, Videhi Institute of Medical Sciences, Bangalore, Karnataka, India
| | - Vanaja Reddy Banda
- Department of Oral Medicine and Radiology, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Naveen Reddy Banda
- Department of Pedodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
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40
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Abstract
Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Masses may arise from any of the mesenteric components: peritoneum, lymphatic tissue, fat, and connective tissue. Cellular proliferation can also arise from infectious or inflammatory processes. They can be classified as solid or cystic, benign or malignant. Mesenteric tumors are usually discovered incidentally or during investigation of non-specific symptoms. While clinical examination and imagery may suffice to make the diagnosis, histopathology is often required by either needle percutaneous or surgical biopsy, or immediate excision. Therapeutic management options vary widely depending on the nature of the lesion; they range from simple observation or medical therapy to surgery. Benign well-delineated mesenteric masses that are symptomatic can often be treated by simple enucleation. But invasive malignant tumors require a carcinologic resection; a careful preoperative evaluation to assess the relationship between the mass and adjacent vascular and digestive structures is essential since they may dictate the need for extensive sacrifice of bowel with resultant intestinal insufficiency due to short bowel syndrome.
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41
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Abstract
Mesenteric cysts are uncommon benign abdominal lesions with no classical clinical features. The preoperative diagnosis requires the common imaging modalities but the final diagnosis is established only during surgery or histological analysis. The treatment of choice is complete surgical excision. We report an 18-year-old female with a non-specific abdominal pain and discomfort since 3 weeks. Her CT scan showed a huge cystic swelling, which necessitated surgical exploration. Preoperatively, a giant cyst was encountered with displacement of bowel loops. The cyst was completely removed and histology report confirmed mesenteric cyst without evidence of malignancy.
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Affiliation(s)
| | - Shaista Salman
- College of Medicine Taibah University, Al Madina Al Munawarah Saudi Arabia
| | - Hamdi H Almaramhy
- College of Medicine Taibah University, Al Madina Al Munawarah Saudi Arabia
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42
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Long CY, Wang CL, Tsai EM. Incidental diagnosis of a mesenteric cyst mimicking an ovarian cyst during laparoscopy. Taiwan J Obstet Gynecol 2011; 50:388-9. [DOI: 10.1016/j.tjog.2011.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2010] [Indexed: 11/30/2022] Open
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43
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Kim EJ, Lee SH, Ahn BK, Baek SU. Acute abdomen caused by an infected mesenteric cyst in the ascending colon: a case report. JOURNAL OF THE KOREAN SOCIETY OF COLOPROCTOLOGY 2011; 27:153-6. [PMID: 21829771 PMCID: PMC3145887 DOI: 10.3393/jksc.2011.27.3.153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 12/23/2010] [Indexed: 11/25/2022]
Abstract
Mesenteric cysts are rare intra-abdominal tumors. Mesenteric cysts are usually asymptomatic and are incidentally detected during physical or radiological examination. Although uncommon, complications such as infection, bleeding, torsion, rupture and intestinal obstruction cause an acute abdomen. Spontaneous infection is a very rare complication. We present a case of infected mesenteric cysts in the ascending colon, which caused an acute abdomen. A 26-year-old woman was admitted to our hospital with acute abdominal pain. She had a painful mass in the right abdomen on physical examination. Abdominal computed tomography showed a hypodense cystic mass with septation at the mesenteric region of the ascending colon. A laparotomy revealed two cystic tumors at the mesenteric region of the ascending colon. She underwent a right hemicolectomy. The two cysts were filled with a yellowish turbid fluid. The walls of both two cysts were lined with a thin fibrotic membrane without any epithelial cell. They were diagnosed as psuedocysts with E. coli infection. Mesenferic cysts may cause life-threatening complications. Mesenteric cyst, even if it is asymptomatic and was diagnosed incidentally, should be removed completely.
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Affiliation(s)
- Eun-Ji Kim
- Department of Surgery, Kosin University College of Medicine, Busan, Korea
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44
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Karim T, Topno M, Kate M. Simple mesenteric cyst in a child: presentation and management. Arab J Gastroenterol 2011; 12:90-1. [PMID: 21684480 DOI: 10.1016/j.ajg.2010.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 03/21/2010] [Accepted: 10/08/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Tanweer Karim
- Department of Surgery, M.G.M. Medical College & Hospital, Kamothe, Navi Mumbai, India.
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45
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Ahmadi MH, Seifmanesh H, Alimohammadi M, Delpisheh A, Yasemi M, Peyman H. Ileal mesenteric cyst in a patient with immediate abdominal emergency: always consider appendicitis. Am J Emerg Med 2010; 29:572.e3-5. [PMID: 20637555 DOI: 10.1016/j.ajem.2010.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 05/09/2010] [Indexed: 11/28/2022] Open
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46
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Karakoc SC, Yetkin G, Citgez B, Uludağ M, Akgün I, Kartal A. A rare case of acute abdomen. BMJ Case Rep 2009; 2009:bcr06.2009.1958. [PMID: 22162732 DOI: 10.1136/bcr.06.2009.1958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mesenteric cysts are tumoural formations which are generally benign in character, originate from the intestinal mesentery, and rarely cause abdominal tumours. They are asymptomatic unless a complication occurs, and thus may be incidentally diagnosed. Symptomatic cases may show up with findings such as abdominal pain, abdominal mass, nausea, and vomiting, and sometimes patients present with an acute abdomen. Treatment includes total excision of the cyst. We present the case of a male patient admitted to our emergency department with acute abdominal symptoms, who was subsequently found to have a mesenteric cyst measuring 30×20×9 cm.
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Affiliation(s)
- Sinan Cumhur Karakoc
- Sisli Etfal Training and Research Hospital, 2nd General Surgery, Etfal Sokak No: 1, Istanbul, 34360, Turkey
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47
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Mesenteric Cysts: An Institution Experience Over 14 Years and Review of Literature. World J Surg 2009; 33:1961-5. [DOI: 10.1007/s00268-009-0133-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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48
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Metaxas G, Tangalos A, Pappa P, Papageorgiou I. Mucinous cystic neoplasms of the mesentery: a case report and review of the literature. World J Surg Oncol 2009; 7:47. [PMID: 19454018 PMCID: PMC2691402 DOI: 10.1186/1477-7819-7-47] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 05/19/2009] [Indexed: 12/13/2022] Open
Abstract
Background Mucinous cystic neoplasms arise in the ovary and various extra-ovarian sites. While their pathogenesis remains conjectural, their similarities suggest a common pathway of development. There have been rare reports involving the mesentery as a primary tumour site. Case presentation A cystic mass of uncertain origin was demonstrated radiologically in a 22 year old female with chronic abdominal pain. At laparotomy, the mass was fixed within the colonic mesentery. Histology demonstrated a benign mucinous cystadenoma. Methods and results We review the literature on mucinous cystic neoplasms of the mesentery and report on the pathogenesis, biologic behavior, diagnosis and treatment of similar extra-ovarian tumors. We propose an updated classification of mesenteric cysts and cystic tumors. Conclusion Mucinous cystic neoplasms of the mesentery present almost exclusively in women and must be considered in the differential diagnosis of mesenteric tumors. Only full histological examination of a mucinous cystic neoplasm can exclude a borderline or malignant component. An updated classification of mesenteric cysts and cystic tumors is proposed.
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Affiliation(s)
- Georgios Metaxas
- University Hospital of South Manchester, The Nightingale and Genesis Prevention Centre, Southmoor Road, M239LT, Manchester UK.
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49
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Patel A, Lefemine V, Ramanand BS. A rare case of a peritoneal cyst arising from the falciform ligament. CASES JOURNAL 2009; 2:134. [PMID: 19203390 PMCID: PMC2645370 DOI: 10.1186/1757-1626-2-134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 02/09/2009] [Indexed: 11/16/2022]
Abstract
Peritoneal cysts are rare benign intra-abdominal lesions most commonly found attached to the mesentery of the ileum. They may be asymptomatic, present with abdominal pain, bloating or discovered incidentally. We describe the case of a peritoneal cyst located in an unusual position in a female patient; attached to the falciform ligament.
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Affiliation(s)
- Anish Patel
- Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, LL18 5UJ, UK.
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50
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Bhattacharjee PK, Rai H, Ram N, Chattopadhyya D, Roy RP. Mesenteric cyst: an unusual presentation. Indian J Surg 2008; 70:247-9. [PMID: 23133074 DOI: 10.1007/s12262-008-0071-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 07/30/2008] [Indexed: 11/28/2022] Open
Abstract
A 5-year-old boy presented with the history of a small lower abdominal swelling since childhood which increased in size and became painful following a fall. Examination revealed a mobile, globular, cystic intraabdominal mass in the lower abdomen. Ultrasonography of the abdomen suggested a 7.5 × 5.5 cm cystic lesion, separate from the bladder, containing an echogenic mobile mass. Intra venous urography excluded any abnormality of the kidneys, ureters and bladder. Exploratory laparotomy revealed a sigmoid mesenteric cyst protruding out of one of the mesenteric leaves and attached to it by a narrow stalk. The excised cyst was found to be thin walled and unilocular. It was internally lined with fibrinous exhudate and contained serous fluid and a solid spherical blood clot. The child had an uneventful postoperative recovery. Histopathology of the cyst wall showed maturing granulation and fibrous tissue with hemosiderin laden macrophages and lymphoid aggregates consistent with the diagnosis of a lymphagioma with chronic inflammatory changes and evidence of past hemorrhage.
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