Mesenteric Venous Malformation Case Report in an Adolescent With Midgut Volvulus

Area of Science:

• Vascular Surgery
• Gastroenterology
• Pediatric Surgery

Background:

• Congenital vascular malformations affect ~1.5% of the population but are difficult to precisely incidence due to heterogeneity and varied terminology.
• Vascular anomalies can involve any vessel type (capillary, lymphatic, venous, arterial) and occur anywhere in the body.
• Mesenteric vascular malformations presenting as gastrointestinal (GI) obstruction are exceptionally rare.

Purpose of the Study:

• To report an unusual case of a mesenteric vascular malformation causing midgut volvulus and small bowel obstruction in an adolescent.
• To emphasize the importance of including vascular anomalies in the differential diagnosis for pediatric patients with abdominal pain and obstruction.
• To advocate for standardized terminology in reporting vascular anomalies to improve diagnosis and research.

Main Methods:

• Case report of an adolescent patient.
• Diagnostic workup including emergent laparotomy.
• Surgical resection of the affected segment of small bowel and the mesenteric lesion.
• Pathological examination of the resected specimen.

Main Results:

• An adolescent presented with symptoms of small bowel obstruction due to midgut volvulus.
• Emergent laparotomy revealed a large, cystic intra-abdominal lesion.
• Pathology confirmed the lesion as a mesenteric venous malformation.

Conclusions:

• Mesenteric vascular anomalies are uncommon but critical considerations in pediatric patients with small bowel obstruction or intra-abdominal masses.
• Prompt diagnosis and surgical intervention are crucial for managing such rare presentations.
• Standardized reporting of vascular anomalies is essential for advancing clinical understanding and research.