Enucleation of a Large Pseudo-Mesenteric Cyst with Hemorrhage and Infection: A Case Report

Pseudo-mesenteric cysts are exceptionally rare lesions, with limited reports of surgical management. This case highlights the novelty of enucleating a large infected pseudo-mesenteric cyst without intestinal resection, emphasizing its clinical significance. We report the case of a 64-year-old man who presented with acute abdomen. Computed tomography revealed a cystic lesion approximately 17 cm in size with an enhanced capsule in the sigmoid mesentery. Emergency surgery was warranted due to severe inflammation and inferior vena cava compression. Initial laparoscopy ruled out appendiceal abnormalities, and laparotomy was performed. Careful dissection along the thickened cyst wall, as seen on preoperative imaging, enabled complete enucleation without the need for intestinal resection. This case demonstrates successful enucleation of a giant pseudo-mesenteric cyst, a rare surgical challenge, highlighting the importance of meticulous surgical planning and technique.