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[Abdominal cystic lymphangiomas in children. Apropos of 6 cases]
T Scheye1, B Aufauvre, G Vanneuville
1Service de Chirurgie Pédiatrique, Hôtel-Dieu, Clermont-Fd.
Insights
Abdominal cystic lymphangiomas are rare pediatric surgical cases, often presenting in the mesentery. Early diagnosis via echography and surgical excision are key, with sclerosis as a potential alternative therapy.
Area of Science:
- Pediatric Surgery
- Vascular Malformations
- Abdominal Imaging
Background:
- Cystic lymphangiomas are uncommon abdominal lesions in pediatric surgery.
- This study reviews cases from a single center over a 15-year period.
Observation:
- Six cases of abdominal cystic lymphangiomas were diagnosed and treated.
- Four cases involved the mesentery, with three exhibiting characteristic chylous contents.
- Presenting signs were diverse, including two instances of acute intestinal volvulus.
Findings:
- Abdominal cystic lymphangiomas are likely underdiagnosed.
- Routine use of echography, particularly prenatal, is expected to increase detection rates.
- Surgical resection remains the primary treatment modality.
Implications:
- Increased recognition and diagnostic capabilities may lead to earlier intervention.
- Sclerosis techniques offer potential alternative or complementary therapeutic options.
- Further research into less invasive treatments for pediatric abdominal cystic lymphangiomas is warranted.
Abstract:
Cystic lymphangiomas are rarely observed in the abdomen, even in a paediatric surgery ward. From 1977 to 1991, we diagnosed and treated six such lesions in our paediatric surgery department in Clermont-Ferrand. Most of the lymphangiomas were seen in boys. Mesenteric localizations were seen in 4 out of 6 cases with the characteristic chylous contents in 3 cases. There were very many different presenting signs, although two acute episodes of intestinal vuvulus occurred. The clinical features and the usefulness of exploratory techniques are discussed. The frequency of abdominal cystic lymphangiomas is probable underestimated although the number of cases diagnosed will undoubtedly rise with routine echography, especially in the ante-natal period. Surgical exeresis is the standard therapy but other alternative or complementary methods such as sclerosis techniques could be of interest.