Mesenteric Venous Malformation Case Report in an Adolescent With Midgut Volvulus

Although the reported incidence of congenital vascular malformations is ~1.5% of the general population, the true incidence of these lesions is difficult to assess due to the heterogeneity of vascular anomalies and the variability in terminology used in reporting. These vascular anomalies can involve capillaries, lymphatics, venous, and/or arterial structures and can occur anywhere in the body. Rarely does a vascular malformation originate from the gastrointestinal (GI) mesentery and present as a bowel obstruction.

This report describes an adolescent patient with an unusual presentation of a vascular malformation involving the GI mesentery, manifesting as midgut volvulus. Emergent laparotomy revealed a large intra-abdominal cystic structure that volvulized resulting in a small bowel obstruction. The lesion and involved segment of small bowel were resected and found to be a mesenteric venous malformation on pathology.

Vascular anomalies of the GI tract are uncommon but should be included in the broad differential for patients presenting with abdominal pain, symptoms consistent with a small bowel obstruction, and/or a cystic intra-abdominal mass. In addition, utilization of accurate and standardized terminology when reporting these lesions is important to facilitate prompt and accurate diagnosis and treatment of patients and to establish a reliable foundation of continued research on vascular anomalies.