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Recurrence of abdominal distension due to fluid accumulation in a child: Ascites or a cyst?

Armineh Barzegar1, Mohammadreza Esmaeili Dooki1, Abbas Hadipour1

  • 1Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Caspian Journal of Internal Medicine
|July 31, 2023
PubMed

Insights

Recurrent abdominal distension in children may indicate mesenteric cysts, even after a normal CT scan post-paracentesis. Early consideration of these cysts aids in accurate diagnosis and timely surgical intervention.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Oncology

Background:

  • Abdominal distension in children is often attributed to fluid accumulation from ascites or large cysts.
  • Differentiating causes of pediatric abdominal distension requires comprehensive diagnostic evaluation.

Observation:

  • A 25-month-old girl presented with recurrent, nontraumatic acute abdominal pain and distension.
  • Previous paracentesis and a normal CT scan for suspected ascites did not resolve the issue.
  • Further investigations, including biochemical parameters and imaging, indicated a large mesenteric cyst.

Findings:

  • The patient's persistent abdominal fluid accumulation, despite initial negative findings, pointed towards a mesenteric cyst.
  • Surgical excision successfully removed the large mesenteric cyst, resolving the symptoms.

Implications:

  • Mesenteric cysts should be considered in pediatric cases of recurrent abdominal fluid accumulation, even with initially normal imaging like CT scans post-paracentesis.
  • This case highlights the importance of considering less common diagnoses when symptoms persist despite conventional workups.
  • Prompt surgical intervention for mesenteric cysts can lead to complete recovery.
Abstract

Keywords:
AscitesCT scanCystic lymphangiomasParacentesis

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