Mesenteric Cystic Lymphangioma Causing Small Bowel Obstruction in a Neonate

Mesenteric cystic lymphangiomas (MCLs) are benign malformations of the lymphatic system that are most commonly diagnosed during childhood. The range of presentation varies with anatomic location. MCLs of the gastrointestinal tract can lead to bowel obstruction, and surgical intervention is warranted for those presenting in the acute setting. We report a case of a female neonate who was brought to the emergency department with a history of 24 hours of bilious emesis and abdominal distention. An abdominal X-ray was suspicious for bowel obstruction, and the patient was emergently taken to the operating room. A cystic lesion was identified in the mesentery of the jejunum, causing volvulus and bowel obstruction. The mass was resected, including the adjacent bowel. Pathology revealed a macrocystic lymphatic malformation (lymphangioma). The patient required total parenteral nutrition in the acute postoperative phase and has since weaned off successfully. The patient was ultimately discharged after an uneventful hospital course and was doing well at her 12-month follow-up. We concluded that MCLs are benign malformations that can be resected at the time of surgery. Due to the benign nature of these lesions, outcomes and prognosis are excellent.