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Updated: Jun 9, 2025

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric cysts
Evghenii Gutu1, Igor Mishin2, Vasile Guzun3
1"Nicolae Testemitanu" State University of Medicine and Pharmacy, "Gheorghe Paladi" Municipal Clinical Hospital No. 1, Chisinau, Republic of Moldova.
Abstract:
<b>Introduction:</b> Mesenteric cysts (MCs) are a rare pathology of the abdominal cavity (with an incidence of 1/27.000 to 1/250.000 admissions) and less than 1000 cases have been described in the specialized literature.<b>Aim:</b> To identify the characteristics of clinical manifestations, diagnostics, and treatment of MCs.<b>Materials and methods:</b> Within 2001-2017, 17 consecutive patients with MCs were observed. Ultrasound scan (n = 17), computed tomography (n = 15), and magnetic resonance imaging (n = 1) were used to diagnose MC.<b>Results:</b> The mean age of patients with MCs was 43.4 3.5 years (range from 19 to 67), with a significant predominance of women (n = 14, 82.4%). The main clinical symptoms of MCs included abdominal pain (n = 9, 52.9%), pain + abdominal discomfort (n = 4, 23.5%), abdominal pain + nausea (n = 2, 11.8%), and abdominal discomfort (n = 2, 11.8%). In 13 (76%) cases, a palpable mass was noted in the abdominal cavity. According to imaging studies, the largest size of the MCs was 12.1 1.2 cm (from 5 to 20 cm) and the smallest - 8.6 0.8 cm (from 4 to 15 cm). The density of MC contents by computed tomography data varied from 2 to 26 HU. All patients underwent surgery via laparotomy. MCs were significantly more often located in the mesentery of the large bowel (n = 14, 82.4%) as compared to the small intestine (n = 3, 17.6%). The MCs of the small intestine in all cases were located in the mesentery of the jejunum, whereas in the colon lesions, they were distributed as follows: cecum (n = 1, 7.1%), ascending colon (n = 3, 21.4%), transverse colon (n = 7, 50%), and sigmoid colon (n = 3, 21.4%). Most MCs (n = 16, 94.1%) were enucleated, and only in one case segmental resection of small intestine with MCs was performed. The histopathological examination revealed: simple mesothelial MC - in 8 (47.1%), simple lymphatic MC - in 7 (41.2%), and lymphangioma - in 2 (11.7%) cases.<b>Conclusions:</b> MC is a rare pathology of abdominal organs. The clinical manifestations of MCs are nonspecific, and the final diagnosis becomes apparent only during surgery. In most cases, it is possible to perform MC enucleation without long-term recurrences.
Insights
Mesenteric cysts (MCs) are rare abdominal pathologies. Surgical enucleation is often successful, with most patients experiencing no long-term recurrences after treatment for these non-specific abdominal conditions.
Area of Science:
- Gastroenterology
- Abdominal Surgery
- Radiology
Background:
- Mesenteric cysts (MCs) are rare abdominal pathologies with low incidence.
- Fewer than 1000 cases of MCs have been documented in medical literature.
Purpose of the Study:
- To characterize the clinical manifestations of MCs.
- To identify diagnostic methods for MCs.
- To evaluate treatment outcomes for MCs.
Main Methods:
- A retrospective analysis of 17 patients with MCs between 2001 and 2017.
- Diagnostic imaging included ultrasound (n=17), CT (n=15), and MRI (n=1).
- Surgical intervention via laparotomy was performed for all patients.
Main Results:
- The majority of patients were women (82.4%) with a mean age of 43.4 years.
- Common symptoms included abdominal pain (52.9%) and palpable abdominal masses (76%).
- MCs were more frequent in the large bowel mesentery (82.4%) than the small bowel.
- Histopathology revealed simple mesothelial cysts (47.1%), simple lymphatic cysts (41.2%), and lymphangiomas (11.7%).
Conclusions:
- Mesenteric cysts are rare and present with non-specific symptoms.
- Diagnosis is often confirmed during surgery.
- Enucleation is typically successful, with a low rate of recurrence.
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