Chylous mesenteric cysts: a rare surgical challenge

Dioscoridi, Lorenzo; Perri, Giampaolo; Freschi, Giancarlo

doi:10.1093/jscr/rju012

Cited by 9 publications

(9 citation statements)

References 8 publications

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“…[ 17 ] 2013 Mesentery near Pancreas tail 22 M Abdominal pain, Vomiting Unknown Open cystectomy Dioscoridi et al . [ 2 ] 2014 Jejunal mesentery, Aorta, IMA 30 M Diffuse abdominal pain 95 × 60 Laparoscopic cystectomy Wang et al . [ 9 ] 2014 Small bowel mesentery 80 F Heavy sweats and shivering 2 × 1.5 × 1 Colectomy for tumor Lee et al .…”

Section: Discussionmentioning

confidence: 99%

“…Mesenteric cysts represent a rare pathologic entity. Their existence was first reported in 1507 by Benevieni, an Italian anatomist, when he performed an autopsy on an 8-year-old boy and the first effective surgical excision was performed in 1880 by Tillaux [ 1 , 2 ]. Mesenteric cysts are identified in approximately 1 out of 100,000 adult hospital admissions [ 1 ] and they are most frequently located in the small bowel mesentery (ileum in 60%), followed by the large bowel mesentery (ascending colon in 24%), the retroperitoneum (14.5%), and the omentum [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Ideal treatment strategy for chylous mesenteric cyst: a case report

et al. 2018

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BackgroundA mesenteric chylous cyst is defined as a cyst occurring in the mesentery of the gastrointestinal tract anywhere from the duodenum to the rectum and is diagnosed most often during the fifth decade of life.Case presentationIn our case report, we describe a case of 38-year-old Greek woman who presented at our Emergency Department complaining of abdominal pain without any other symptoms. Her medical and family histories were clear and she had never had any abdominal interventions. During an imaging examination with ultrasound of her abdomen, an anechoic lesion in her upper left abdomen was revealed. In a further investigation with computed tomography, a well-defined hypodense cystic 7.08 × 6.05 cm mass with mild enhancement was noted. The mass was excised by open laparotomy within healthy borders and the specimen was sent for pathological examination. The histopathological findings were found to be most consistent with a simple lymphatic (chylous) cyst of the mesentery. A review of the literature considering this rare entity was also performed to evaluate our treatment strategy and the result was analyzed.ConclusionsChylous cysts represent a diagnostic challenge and they should be considered when a physician encounters an intraabdominal mass. Physical examination and imaging do not always provide a diagnosis and surgical management should be advised due to the potential complications that may develop.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ideal treatment strategy for chylous mesenteric cyst: a case report

et al. 2018

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“…The cysts can be asymptomatic and on average 50% are detected incidentally [ 2 ] through abdominal ultrasonography, CT, or magnetic resonance imaging (MRI) [ 6 ]. Ultrasonography is a pivotal tool in the first-line assessment of mesenteric lesions and supplementation with a CT scan may help in the planning of the surgical approach [ 8 ]. The most common symptoms related with mesenteric cysts are abdominal pain and distension, according to the size and the location of the cysts, as well as the consequential abdominal organ compression (hydronephrosis, lower extremity lymphedema, intestinal obstruction).…”

Section: Discussionmentioning

confidence: 99%

Mesenteric cysts and mesenteric venous thrombosis leading to intestinal necrosis in pregnancy managed with laparotomy: a case report and review of the literature

et al. 2017

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BackgroundMesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation.Case presentationA 27-year-old Greek woman, gravida 2 para 1, presented at 10 weeks’ gestation to the Emergency Unit of our hospital complaining of diffuse abdominal pain which deteriorated the last 3 days, which was localized in her right iliac fossa, along with vomiting. She had undergone open laparotomy and right salpingo-oophorectomy at the age of 23 due to an ovarian cyst. Besides this, her personal and family medical history was unremarkable. She had never received oral contraceptives or any hormone therapy. On arrival, a clinical examination revealed tenderness on palpation of her right iliac fossa, without rebound tenderness or muscle guarding. Within 10 hours of hospitalization, her symptoms deteriorated further with rebound tenderness during the examination, tachycardia, and a drop of 12 units in her hematocrit value. An emergency laparotomy was performed. Two mesenteric cysts and a 60 cm necrotic part of her intestine were revealed intraoperatively. In the postoperative period, she complained of acute abdominal pain, tachycardia, and dyspnea. Computed tomography imaging revealed mesenteric vein thrombosis and pulmonary thromboembolism. She was treated with low molecular weight heparin and she was discharged on the 11th postoperative day.ConclusionsTo the best of our knowledge, this is the first report in the literature of a simultaneous mesenteric cyst and mesenteric vein thrombosis in pregnancy. It is known that pregnancy is a state of hypercoagulation and clinicians should bear in mind this rare clinical condition in their diagnostic algorithm for acute abdominal pain.

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“…symptoms. It is a rare disease, but surgeons must consider the diagnosis in the presence of a cystic abdominal tumor [9]. Amyand's hernia has variability in presentation that makes it difficult to diagnose clinically in infant and mostly identified intraoperatively.…”

Section: Learn More Biomedcentralcom/submissionsmentioning

confidence: 99%

Amyand’s hernia associated with mesenteric chylous cyst in infant: a rare case report

Supangat

Nugraha

Margaretha³

2020

BMC Surg

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Background Amyand’s hernia is a rare condition approximately 0.4–0.6% of all inguinal hernias. Although rare, the Amyand’s hernia is worthy of discussion since the variable presentation that make clinical challenge to diagnose especially in infant. A mesenteric chylous cyst is rare disease and has not been reported in Amyand’s hernia. Case presentation We report an unusual case of Type II Amyand’s hernia with an enlarging chylous mesenteric cyst on the retrocaecal in the anulus into canalis inguinalis. A-2-months old infant presented with enlarging mass in the right scrotal. During laparotomy exploration, we found inguinal sac with intestinal and appendix content in the sac. In the edge site of the sac we found enlarging of mesenteric cyst on the retrocaecal in the anulus into canalis inguinalis. Based on the histopathology examination, the morphological feature is suitable for mesenteric chylous cyst appearance. Conclusion Presentation of mesenteric chylous cyst is rare, and there was no report about it in Amyand’s hernia. This unusual presentation should be considered by the surgeon, especially pediatric surgeon, in Amyand’s hernia cases.

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Chylous mesenteric cysts: a rare surgical challenge

Cited by 9 publications

References 8 publications

Ideal treatment strategy for chylous mesenteric cyst: a case report

Ideal treatment strategy for chylous mesenteric cyst: a case report

Mesenteric cysts and mesenteric venous thrombosis leading to intestinal necrosis in pregnancy managed with laparotomy: a case report and review of the literature

Amyand’s hernia associated with mesenteric chylous cyst in infant: a rare case report

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