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Abdominal cystic lymphangiomas in pediatrics: surgical approach and outcomes
R Méndez-Gallart1, A Bautista, E Estévez
1Department of Pediatric Surgery, Santiago University Hospital, Santiago de Compostela, A Coruña, Spain. roberto.mendez.gallart@sergas.es
Insights
Abdominal cystic lymphangiomas (ACL) are rare benign tumors in children. Surgical excision is a safe and effective treatment, preventing serious complications.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Abdominal Imaging
Background:
- Abdominal cystic lymphangiomas (ACL) are rare benign pediatric masses.
- While uncommon, ACL can lead to severe complications, necessitating surgical intervention.
Purpose of the Study:
- To report the experience with diagnosis and surgical treatment of pediatric abdominal cystic lymphangiomas.
- To analyze clinical presentation, imaging, and surgical outcomes for ACL in children.
Main Methods:
- Retrospective review of 10 pediatric patients diagnosed with ACL between 1994 and 2009.
- Analysis of clinical data, imaging studies (ultrasonography, MRI), surgical approaches, and pathological findings.
Main Results:
- Abdominal pain was the most common symptom; three cases were incidental findings.
- Ultrasonography was the primary diagnostic tool; MRI was used in later cases.
- Complete excision was successful with no recurrence during a mean 5.1-year follow-up; one case had adhesions.
Conclusions:
- ACL present with varied symptoms, from incidental findings to life-threatening obstruction.
- Complete surgical excision is a safe and effective management strategy for pediatric ACL.
- Surgery is essential to prevent potential complications associated with abdominal cystic lymphangiomas.
Background:
Abdominal Cystic lymphangiomas (ACL) are uncommon benign masses usually presented during infancy. Although extremely rare, they may cause complications; therefore, the recommended therapy is surgical excision. The purpose of this study is to report our experience with the diagnosis and surgical treatment of ACL in pediatric population.
Material And Methods:
From January 1994 to December 2009, 10 patients (6 females; 4 males) with diagnostic confirmation of ACL were retrospectively included in study. Children's age ranged between 9 months and 8 years (mean age at diagnosis was 2.5 years). Clinical presentation, cyst location, imaging studies employed, surgical approach and pathologic features were analyzed.
Results:
The most common symptom was abdominal pain but three cases were incidentally detected. One case had presented with acute abdomen after traumatic haemorrhage of the tumor. All patients were diagnosed with ultrasonography as first-line radiological study. MRI was used in last three cases. At surgery, concomitant bowel resection was necessary in 3 children. Location of the lesion (omentum, mesentery) did not influence the outcome but surgery was more difficult (operative time over three hours) in patients with lymphangioma affecting mesentery of the jejunum. Mean hospital stay after surgery was 6.7 days. Mean follow-up was 5.1 years. No recurrence of the cystic lymphangioma was noticed during follow-up. One case developed an intestinal occlusion due to bowel adhesions 1 year after surgery.
Conclusions:
ACL usually affect infants and young children and may present with spectrum of symptoms from an incidental finding to an acute life-threatening abdominal obstruction. Complete excision of the tumor is a safe and effective method in the management of ACL in pediatric population. Surgery is mandatory to avoid potential complications.