Comprehensive Analysis of Pediatric Mesenteric Cysts with Clinical Presentation, Diagnostic Challenges, Surgical...

Mesenteric cysts are rare, benign abdominal tumors that pose diagnostic challenges due to their nonspecific symptoms. Their etiology is diverse, with congenital, lymphatic, and inflammatory origins proposed. Clinical presentation often includes abdominal pain, mass, or incidental findings. Management primarily involves surgical resection, yet the optimal approach and long-term outcomes remain unclear. This study aims to comprehensively characterize the clinical spectrum, diagnostic accuracy, therapeutic strategies, and prognostic factors associated with mesenteric cysts.

The authors retrospectively analyzed prospectively maintained data on cystic abdominal masses managed between 2014 and 2024. They analyzed the clinical parameters, demographics, presentations, investigations, management, and outcomes.

The authors managed 28 cases of cystic abdominal masses between 2014 and 2024. The median age of presentation was 36 months (range 2 days-9 years), with 16 males and 12 females. The most common presenting symptom was abdominal pain (n = 18) - seven children presented with acute symptoms in casualty. There were 13 mesenteric cysts, six enteric duplication cysts, five chylolymphatic cysts, three omental cysts, and one retroperitoneal lymphatic cyst. Thirteen cysts were present in the ileum, seven in the jejunum, three in the transverse colon mesentery, two in the omentum, and one each in the rectal, retroperitoneum, and lower esophagus (traversing the hiatus to lie in the abdomen). Cyst excision was done in 10 patients, and cyst excision with resection and anastomosis was done in 13 patients. One patient expired in the immediate postoperative period due to sepsis; others had uneventful postoperative periods with no recurrence on follow-up.

This article highlights the clinical presentation, diagnostic challenges, and management strategies employed in a patient with cystic abdominal masses. Despite challenges in locating the site of origin of these cysts, timely intervention with radiology and surgery led to a favorable outcome.