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The tonicity of a solution determines if a cell gains or loses water in that solution. The tonicity depends on the permeability of the cell membrane for different solutes and the concentration of nonpenetrating solutes in the solution within and outside of the cell. If a semipermeable membrane hinders the passage of some solutes but allows water to follow its concentration gradient, water moves from the side with low osmolarity (i.e., less solute) to the side with higher osmolarity (i.e.,...
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A Case of Mesenteric Pseudocyst Causing Massive Abdominal Swelling.

Cláudia Raquel Barbosa Rosado1, Daniela Santos Machado2, Joel de Magalhães Esteves2

  • 1Department of Internal Medicine, Centro Hospitalar do Baixo Vouga E.P.E., Aveiro, Portugal.

European Journal of Case Reports in Internal Medicine
|February 14, 2019
PubMed
Summary

A rare intra-abdominal cystic mass, a mesenteric pseudocyst, can present years after an initial illness. Histopathological examination is essential for diagnosis, as imaging alone may be inconclusive.

Keywords:
Mesenteric pseudocystabdominal cystperitoneal fluid

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Mesenteric pseudocysts are uncommon intra-abdominal cystic masses.
  • They are often benign and asymptomatic, posing diagnostic challenges.

Purpose of the Study:

  • To highlight the diagnostic challenges of mesenteric pseudocysts.
  • To emphasize the importance of histopathological examination for definitive diagnosis.

Main Methods:

  • Case presentation of a 55-year-old man with polyserositis.
  • Delayed presentation with an abdominal mass diagnosed as a mesenteric pseudocyst via surgical resection and histology.
  • Review of diagnostic imaging modalities including ultrasound, CT, and MRI.

Main Results:

  • Initial febrile illness with polyserositis resolved, with inconclusive investigations.
  • A mesenteric pseudocyst was diagnosed 2 years later via surgical resection and histopathology.
  • Imaging suggested a cystic lesion, but histology confirmed the diagnosis.

Conclusions:

  • Mesenteric pseudocysts present a diagnostic challenge due to their rarity and often nonspecific symptoms.
  • Abdominal imaging may reveal fluid lesions that can delay diagnosis.
  • While imaging aids in pre-operative diagnosis, histopathological examination is mandatory for definitive differentiation.