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Giant omental cyst in children presenting as pseudoascites
1Department of Pediatric Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
Insights
A rare omental cyst caused a child to be repeatedly hospitalized for unexplained ascites. Surgical intervention, following diagnostic laparoscopy, successfully treated the condition, resolving all symptoms.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Ascites of unknown origin in children presents a diagnostic challenge.
- Omental cysts are rare intra-abdominal masses that can mimic other conditions.
- Recurrent paracentesis offers only temporary relief for symptomatic ascites.
Observation:
- A pediatric patient presented with recurrent ascites over three years, necessitating multiple hospitalizations.
- Extensive diagnostic workups, including imaging and laboratory tests, failed to identify the cause of ascites.
- Despite repeated paracentesis, the patient experienced only transient symptom improvement.
Findings:
- Diagnostic laparoscopy revealed an omental cyst as the underlying cause of the ascites.
- Explorative laparotomy confirmed the diagnosis and allowed for complete surgical excision of the cyst.
- Histopathological examination confirmed the nature of the omental cyst.
Implications:
- This case highlights the importance of considering rare diagnoses like omental cysts in pediatric ascites.
- Laparoscopy and laparotomy are crucial for definitive diagnosis and treatment of such conditions.
- Timely surgical management of omental cysts leads to complete resolution of symptoms and improved patient outcomes.
Abstract:
An unusual case of omental cyst is described. During a period of 3 years, a child was hospitalized seven times in five different hospitals for evaluation of ascites of unknown origin. Extensive and repetitive diagnostic workup did not reveal the cause of his problem, and recurrent paracentesis improved his condition partially, but for very short periods. A diagnostic laparoscopy, followed by explorative laparotomy, led to the correct diagnosis and appropriate surgical treatment, with complete relief of his complaints.