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Mesenteric cyst in infancy: presentation and management
Samia Belhassen1,2, Braiki Meriem1, Laamiri Rachida1,2
1University Hospital of Monastir, Department of Pediatric Surgery, Monastir, Tunisia.
Insights
Mesenteric cysts, rare pediatric intra-abdominal tumors, present with non-specific symptoms. Complete surgical removal is the recommended treatment, offering excellent outcomes with no recurrence observed in this study.
Area of Science:
- Pediatric Surgery
- Abdominal Imaging
- Surgical Pathology
Background:
- Mesenteric cysts are rare, benign intra-abdominal tumors in children with unknown causes.
- Non-specific symptoms necessitate a high index of suspicion for timely diagnosis and management.
Observation:
- Three pediatric cases of mesenteric cysts (ages 10 days to 5 years) were managed.
- Two patients presented with intestinal obstruction; diagnosis was aided by ultrasonography and CT scans.
- All cysts were completely excised, with histopathology confirming benign mesothelial cysts.
Findings:
- Complete surgical excision of mesenteric cysts is effective in pediatric patients.
- Post-operative follow-up showed no recurrence in the managed cases.
- Imaging modalities like ultrasonography and CT are crucial for preoperative diagnosis.
Implications:
- Early diagnosis and surgical management of pediatric mesenteric cysts lead to favorable outcomes.
- Understanding the imaging characteristics aids in differentiating these benign lesions from other intra-abdominal pathologies.
- This case series highlights the importance of surgical intervention for complete resolution and prevention of recurrence.
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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