Mesenteric cyst: sonographic findings

Repeated ultrasound tests could be used to identify an isolated gastric duplication cyst before surgery

A toddler girl was diagnosed with intra-abdominal simple cyst in the splenic flexure at the gestational period. Due to a severe fever that persisted for 6 days, she was admitted to the emergency room. The diagnosis of intraperitoneal cyst infection was made after contrast-enhanced CT revealed an enlarged cyst and a heterogeneous contrast effect on the cyst wall. A double-wall sign was observed on the cyst wall during continuous ultrasound follow-up, which led to the preoperative diagnosis of the cyst as a duplication cyst. The double-wall sign and cyst peristalsis were identified via successive ultrasound examinations to support the cyst diagnosis. Identifying a duplication cyst based solely on symptoms alone is difficult because the condition may present in different ways.

Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female

A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst.

Laparoscopic Excision of Large Intra-Abdominal Cysts in Children: Needle Hitch Technique

Laparoscopic surgery has both diagnostic and therapeutic advantages in the management of intra-abdominal cysts in children. Large cysts in small children pose technical challenges during laparoscopic surgery, requiring multiple incisions and advanced laparoscopic skills. This paper describes a novel laparoscopic technique using minimal manipulation for both aspiration and excision of the cyst. This simple, safe, and effective approach was used to achieve traction and facilitate excision of a large intra-abdominal cyst in a neonate and a young child.

[Infected jejunal mesenteric pseudocyst: A case report]

BACKGROUND

Mesenteric cysts are very rare abdominal growths, generally asymptomatic, and which are usually detected incidentally while performing a physical examination or an imaging test. Complications such as infections, haemorrhage, torsion, rupture, or bowel obstruction, are seldom found in this pathology, but they can be a cause of acute abdomen. The purpose of this report is to describe the characteristics and the clinical outcome of a male patient with an infected mesenteric pseudocyst of the jejunum.

CLINICAL CASE

A 49 year-old male was admitted to the emergency department with 6-day onset of abdominal pain, bowel obstruction signs, palpable tumour located in the upper hemi-abdomen, systemic inflammatory response syndrome, 36,100/mm(3) white cells, 4.21 ng/ml procalcitonin, abdominal computed tomography scan with evidence of a mesenteric cystic tumour. An exploratory laparotomy was performed, finding the presence of a mesenteric pseudocyst of the jejunum with infection signs, extirpated and sent for histopathological examination. The clinical progress of the patient was satisfactory with the discharge of the patient 7 days after the surgical intervention.

CONCLUSION

These cysts can debut as an acute abdomen due to haemorrhage, infection, obstruction and/or bowel perforation, complications can be life threatening if not detected and surgically treated at an early stage by performing a resection of the pseudocysts, with or without bowel resection, depending on the location and the size of the cyst.

The disappearing abdominal mass: mesenteric pseudocyst

INTRODUCTION

Mesenteric pseudocyst is a term used to describe an abdominal cystic mass with an unknown abdominal origin. They are rare intra-abdominal masses, with a reported incidence of approximately 1 per 100,000 to 250,000 hospital admissions. Most cysts are benign and they may present differently, such as a disappearing mass or a mass that changes locations, thus posing a diagnostic challenge to the clinician.

CASE REPORT

We describe a case of a 29-year-old woman who presented with a 2-year history of feeling a large mass within her abdomen, which would then disappear for several days and would frequently change position and be felt in different quadrants of her abdomen. Computed tomography scan of the abdomen revealed a large cystic structure, and a computed tomography- guided biopsy was inconclusive. Diagnostic laparoscopic surgery revealed a firm mass arising from the jejunal mesentery; the patient underwent an en bloc resection. Histopathologic examination of the resected mass revealed a rare diagnosis of mesenteric pseudocyst. Mesenteric pseudocyst should be should be kept high on the list of differential diagnoses when a patient presents with a disappearing mass and/or an abdominal mass that changes location.

Acute abdomen caused by an infected mesenteric cyst in the ascending colon: a case report

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.

[Mesenteric cyst--clinical and pathological aspects]

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.

Mesenteric cystic masses: a series of 21 pediatric cases and review of the literature

Mesenteric cysts, seen in all age groups, represent a rare cause of benign abdominal masses in children. We reviewed 21 patients with mesenteric/omental cysts. Gross and radiologic images, along with histologic sections, were reviewed to categorize the structures and determine the relationship to the mesentery and intestines. The cysts were composed of multi-loculated dilated channels at the serosal surface consistent with lymphangioma. Most treatment was simple excision, infrequently with intestinal resection. Nineteen patients did well after surgery. One patient developed short-gut syndrome after massive bowel resection, and one patient died immediately after birth due to massive fetal hydrops and heart failure.

Large mesenteric cyst mimicking tuberculous ascites

Background. Intraabdominal lesions such as mesenteric cysts are uncommon disorders. Most are discovered incidentally during routine abdominal examinations. Methods. We report a patient with a mesenteric cyst masquerading as tuberculous peritonitis and ascites. Conclusion. Mesenteric cysts generally do not show typical clinical findings. They may also present with peritoneal tuberculosis findings such as low albumin gradient ascites with high ascitic adenosine deaminase levels. Surgery is used to remove a wide variety of mesenteric cysts. A correct diagnosis can be made by the combined use of radiographic and sonographic examinations in conjunction with the clinical signs.

Laparoscopic management of mesenteric cyst: a case report

Mesenteric cysts are rare intra-abdominal lesions with variable clinical symptoms and signs that make pre-operative diagnosis difficult. Optimal treatment is surgical excision of the cyst with laparotomy or laparoscopy. We present a case of mesenteric cyst that was misdiagnosed as para-ovarian cyst and managed laparoscopically by gynaecologists.