Mesenteric Cyst: A Case Report

Mesenteric Cyst: A Rare Entity

Mesenteric cysts are rare entities that are challenging to diagnose and treat because of their variable presentation and histological characteristics. They have been majorly classified into six groups, out of which, the chylo-lymphatic type is the most common. Their etiology remains poorly understood but is usually linked to lymphatic pathologies. They are thin-walled cysts, present in the mesentery of the gastrointestinal tract. They can mimic multiple other cysts; hence, their timely diagnosis is of utmost importance. Imaging techniques aid in the preoperative diagnosis along with a thorough physical exam. The mainstay of treatment is surgical excision of the cyst, which is essential to prevent the recurrence of malignant transformation; the usual method of removal is laparoscopy. Alternative treatments are aspiration and marsupialization, which are only utilised for specific cases. The recurrence rate is usually low after total excision, but follow-ups are recommended for early detection of recurrence. This case study highlights the significance of prompt diagnosis and proper management of mesenteric cysts.

Intact Excision of a Mesenteric Pseudocyst

Mesenteric cysts are detected in all age groups with almost equal incidence in both genders. Although a rare abdominal growth, it is commonly found in the fifth to seventh decades of life. These are mostly small (asymptomatic) with a 3% chance of malignant transformation. With the increase in the size of the cyst, nonspecific complaints of abdominal pain, distention, discomfort, nausea, vomiting, flatulence, constipation, or diarrhea may develop. Owing to the varied presentation and lack of pathognomonic clinical, laboratory, or imaging findings, these are difficult to diagnose. The subtype mesenteric pseudocyst is even rarer with a reported incidence of less than 1 out of 250,000 hospital admissions and can be found anywhere along the mesentery from the duodenum to the rectum. Etiology is either traumatic or infectious. Incidental diagnosis during abdominal imaging or laparotomy is common. However, it warrants immediate surgical intervention when infected or ruptured. Complete excision of the cyst is the treatment of choice. Here, we report an interesting case of a middle-aged gentleman who had been repeatedly evaluated for a tense abdomen with exudative ascites. Following decompression, he presented to us with a large obliquely mobile mass in the abdomen. The diagnosis was made by clinical and radiological findings and confirmed by histopathological examination of the intact, excised specimen post-laparotomy.