The diagnosis and treatment of a symptomatic mesenteric cyst

[Surgical treatment of mesenteric cyst of small bowel]

A rare case of surgical treatment of mesenteric cyst of the small bowel is described. The diagnosis was confirmed by irrigography and contrast-enhanced computed tomography of the abdomen. The patient underwent small bowel and mesentery resection with subsequent entero-enteroanastomosis. Postoperative period was uneventful. This case confirms advisability of total en-bloc excision of the cyst via resection of intact mesentery and small bowel segment. Literature data indicate that the only treatment method for mesenteric cysts is surgery.

Painful Abdominal Lump in the Pediatric Age Group: A Diagnostic Dilemma

Any cystic lesion occurring in the mesentery which may or may not extend into the retroperitoneum is referred to as a mesenteric cyst; they have an infrequent incidence rate in the pediatric age group. Definitive etiology of the cystic lymphatic malformations is still not known but there are multiple hypotheses. A young male child presented with acute onset abdominal pain and palpable intra-abdominal mass and ultrasonography revealed presence of two lesions, one of them as an encysted turbid fluid collection in the right lumbar region and the other as a dilated, tortuous, intercalated structure. On CT, the first one was identified definitively as a mesenteric cyst while the other as a possible neoplastic mass in close proximity to the first one. Histopathology confirmed the diagnosis as a cystic lymphatic malformation of the mesenteric cyst. The limited awareness of its existence along with its usually asymptomatic nature, are the likely reasons that it still remains an elusive diagnosis. Based on our case we discuss, the use of a multi-modality approach towards diagnosing cystic malformation disorders and how the use of MRI is under-utilised when it could prove decisive.

Management of a huge symptomatic hemorrhagic mesenteric cyst

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.

Mesenteric cyst presenting with acute abdomen pain and bowel obstruction: Case report and brief literature review

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.

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Mesenteric cysts are a rare cause of intraabdominal mass.

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Mesenteric cyst should always be considered it whenever the patient has an intraabdominal palpable mass.

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Computed tomography of the abdomen can help find the diagnosis in many cases.

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Even when mesenteric cyst is diagnosed incidentally, surgery should always be indicated in order to prevent complications.

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Surgery is the treatment of choice and recurrence rate is low when the correct treatment is performed.

Complexities of Diagnosing and Treating a Mesenteric Cyst in a Chronic Myeloid Leukaemia Patient

Mesenteric cysts are a rare nosologic entity, the diagnosis of which is complex due to their nonspecific presentation. They may emerge from any part of the mesentery and grow to any size, thus conditioning a wide range of clinical manifestations that renders them easily mistaken for different gastrointestinal pathologies. Diagnosis encompasses a mixture of clinical suspicion, imaging techniques and sometimes surgery, and curative treatment is based on complete surgical resection of the cyst. We hereby present a case of a mesenteric cyst that developed on the anterior abdominal wall of a 59-year-old man awaiting allogeneic bone marrow transplantation after being diagnosed with chronic myeloid leukaemia. He was admitted to the emergency room with complaints of an increased abdominal perimeter and increased weight, not associated with alterations to his dietary or physical exercise habits. Suspecting ascites in the context of leukaemic progression, the patient was admitted to the medical ward; however, subsequent study identified a mesenteric cyst as the most probable diagnosis and the patient was proposed to undergo surgery. He underwent laparotomic cyst excision without complications and the histological evaluation of the surgical specimen confirmed the diagnosis.

LEARNING POINTS

Although rare entities, mesenteric cysts should be suspected whenever nonspecific gastrointestinal symptoms are present and liquid collections are identified.Treatment consists of complete surgical excision, which, although not free of complications, is usually safe and the recurrence rate is very low.In light of the lymphatic theory with respect to the aetiology of mesenteric cysts, this nosologic entity should be highly suspected in oncologic patients where lymphangiogenesis is potentiated.

In Vitro Anti-Inflammatory, Anticancer (MCF-7, 3T3, and HeLa Cell Lines), and Brine Shrimp Lethality Assay and FTIR Analysis of the Extract and Fractions of the Whole Plant of Heliotropium europaeum

In this study, anti-inflammatory, anticancer, brine shrimp lethality, and FTIR studies were evaluated. The oxidative burst assay using the chemiluminescence technique, MTT assay, brine shrimp lethality assay, and FTIR analysis were the methods used for the evaluation of anti-inflammatory, anticancer, brine shrimp lethality, and FTIR studies, respectively. The whole-plant butanol fraction of Heliotropium europaeum (WBFHE) showed anti-inflammatory activity on ROS having IC5014.7 ± 2.5 while the extract and other fractions of the whole plant of Heliotropium europaeum exhibited no anti-inflammatory activity. None of the extract and fractions of the whole plant of Heliotropium europaeum exhibited anticancer (MCF-7, 3T3, and HeLa cell lines) activities. The whole-plant aqueous fraction of Heliotropium europaeum (WAFHE) and whole-plant butanol fraction of Heliotropium europaeum (WBFHE) showed lethality at high concentration while at low concentration, no toxicity was shown. The whole-plant methanolic extract of Heliotropium europaeum (WMEHE) and whole-plant n-hexane fraction of Heliotropium europaeum (WHFHE) exhibited no toxicity. FTIR interpretation showed the functional groups for the aromatic compounds, phenols, carboxylic acids, esters, alkanes, alkenes, alcohols, alkyl halides, sulfate esters, phosphines, silanes, nitriles, thiols, amines, phosphoric acids, and nitro compounds.

Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature

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.