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Chylous mesenteric cyst in children -A case report in a 4-year-old boy
1Airlangga University, Faculty of Medicine, Department of Surgery, Jalan Mayjen. Prof. Dr. Moestopo 6-8 Surabaya, Jawa Timur, Indonesia 60119 Seta.fransiskus@gmail.com.
Insights
A rare giant mesenteric cyst containing chylous fluid was diagnosed in a 4-year-old boy. Surgical resection was successful, confirming a mesenteric cystic lymphangioma.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Abdominal Imaging
Background:
- Chylous mesenteric cysts are exceptionally rare, often presenting with nonspecific symptoms, making preoperative diagnosis challenging.
- Postoperative complications frequently include abdominal pain and distention.
Purpose of the Study:
- To report a rare case of a giant mesenteric cyst in a pediatric patient.
- To highlight diagnostic challenges and successful surgical management.
Main Methods:
- A 4-year-old boy presented with an abdominal mass.
- Initial ultrasound was inconclusive; a repeat scan suggested lymphangioma.
- Exploratory laparotomy revealed a large mesenteric cyst; surgical resection and anastomosis were performed.
Main Results:
- A giant mesenteric cyst (20cm diameter) containing chylous fluid was identified in the ileal mesentery.
- The cyst caused luminal narrowing of the adjacent bowel.
- Histopathology confirmed a giant mesenteric cystic lymphangioma.
Conclusions:
- Giant mesenteric cystic lymphangioma is a rare pediatric surgical condition.
- Multimodality imaging can aid diagnosis, but exploratory laparotomy is often necessary.
- Surgical resection is the definitive treatment for symptomatic mesenteric cysts.
Abstract:
Chylous mesenteric cyst is a very rare case, with some vague clinical findings, and it is hard to establish the diagnosis before surgery. The most common complaints post-surgery are abdominal pain and abdominal distention. We report a case of chylous mesenteric cyst in a 4-year-old boy with chief complaint of a lump in the abdomen. Preoperative abdominal ultrasound study could not identify the origin of the mass, and suspected it as a tuberculous peritonitis. A repeat ultrasound examination revealed a multicystic mass, suspected as lymphangioma. From the exploratory laparotomy, we noted a giant mesenterial cyst (20cm in diameter) containing chylous fluid within the ileal mesentery situated 30cm from the ileocaecal junction and made an effect of diminution of the bowel lumen above it, resection and end to end anastomoses was done. Histopathology examination confirmed it as a giant mesenteric cystic lymphangioma.
