A Rare Case of a Mesenteric Cyst

Abstract

A mesenteric cyst is an uncommon ailment that can affect practically any abdominal quadrant in its presentation. They may turn up as an accidental discovery. Although there are a number of hypotheses explaining the genesis of these cysts, the exact etiology is unknown. A 70-year-old female patient came to see us complaining of abdominal pain for a month and had trouble passing stools for 15 days. Contrastenhanced computed tomography was done for the patient, which revealed a heterogeneously enhancing mass lesion in the abdominal cavity. The patient was then taken for an exploratory laparotomy procedure. To make the procedure thorough and easy, intraoperative partial drainage of the cyst fluid was carried out. We were able to observe the margins of the mesenteric cyst more easily as the partial drainage was carried out. The partial drainage decreased the volume and size of the mesenteric cyst, reducing the pressure effect on the surrounding structures and allowing easy mobilization of the intraabdominal structures during intraoperative examinations. The partial drainage of the cystic fluid also made the dissection process safer. After releasing all adhesions, the cyst was delivered outside and sent for histopathological analysis. The histopathological reports confirmed it to be a mesenteric cyst. The aim of this article is to educate the readers and to make fellow surgeons well aware of this condition. This will not only help fellow clinicians in better diagnosis and treatment but also help in the reduction of the overall burden of the healthcare society by reducing mortality and morbidity.

Cisto de mesentério: um relato de caso

“…Tem maior incidência no intestino delgado, principalmente no segmento ileal. O tipo histológico mais comum é o quiloso ou linfático, formado a partir de defeitos no linfático, com conteúdo turvo semelhante ao quilo [1,6,8,9]. Podem ser uni ou multiloculares, podendo variar de alguns milímetros a vários centímetros de diâmetro [1,2,3,8,9] Normalmente são assintomáticos, sem achados patognomônicos.…”

“…O tipo histológico mais comum é o quiloso ou linfático, formado a partir de defeitos no linfático, com conteúdo turvo semelhante ao quilo [1,6,8,9]. Podem ser uni ou multiloculares, podendo variar de alguns milímetros a vários centímetros de diâmetro [1,2,3,8,9] Normalmente são assintomáticos, sem achados patognomônicos. Os sintomas, quando presentes, estão relacionados ao tamanho, à localização e ao aparecimento de complicações, como torção, obstrução intestinal, hemorragia, infecção, isquemia mesentérica e ruptura traumática do cisto.…”

“…O principal diagnóstico diferencial é o cisto de ovário; outros são cisto pancreático, aneurisma de aorta, apendicite agudo, volvo, obstrução intestinal, entre outros, a depender da clínica apresentada e dos exames complementares [1,3,6,8,9]. O tratamento consiste em exérese da lesão, preferencialmente por via laparoscópica, podendo chegar a grandes ressecções de mesentério e intestino, de acordo com o grau do acometimento das estruturas adjacentes.…”

Mesenteric Cyst: A Rare Entity

“…The majority of mesenteric cysts are benign lesions, although they frequently appear with a variety of nonspecific symptoms, including nausea, vomiting, anorexia, stomach pain, and changes in bowel patterns [ 3 , 6 ]. Palpable masses, obstructive uropathies, and intestinal obstructions are possible in advanced stages [ 7 ]. Other emergency scenarios include the cyst rupturing into the peritoneum and causing peritonitis, volvulus, ileus, infection, perforation, and haemorrhage [ 8 ].…”

“…The differential diagnosis of mesenteric cyst includes numerous other cysts like gastrointestinal duplication, paratubal, pancreatic, ovarian, adrenal, choledochal, splenic, renal, omental, hydatid, omphalomesenteric duct, urachal cyst, and other pathologies like hydronephrosis, and ascites [ 10 ], which can be distinguished with a complete radiological investigation, physical examination, and history collection. The fluid inside the cyst may have a variety of properties, including being hemorrhagic, serous, chylous, or polluted [ 7 ].…”