Cyst in the Mist: A Surgical Perspective on Mesenteric Cysts

A 32-year-old woman presented with dull, non-radiating lower abdominal pain that had persisted for two months and intensified over the preceding 15 days. She reported no gastrointestinal or urinary symptoms. Abdominal examination revealed a soft, non-tender, freely mobile mass measuring approximately 10 × 15 cm in the right iliac fossa. Differential diagnoses included ovarian cyst, uterine fibroid, and mesenteric cyst. Routine blood investigations were within normal limits. Ultrasonography revealed a large anechoic cystic lesion in the right iliac fossa and a smaller pelvic cyst. A contrast-enhanced CT scan confirmed the presence of a well-defined, unilocular, thin-walled mesenteric cyst measuring 12 × 15 cm, along with a smaller ovarian cyst measuring 4.5 × 3 cm. The patient underwent elective exploratory laparotomy, during which both cysts were successfully excised. Histopathological examination confirmed benign cysts lined by flat to cuboidal epithelium. Postoperative recovery was uneventful. This case highlights the importance of early imaging and timely surgical intervention in achieving accurate diagnosis and preventing complications associated with mesenteric cysts.