Giant mesenteric cyst from the small bowel mesentery in a young adult patient

Abstract

Mesenteric cysts are rare tumors, they can emerge from any part of the mesentery of the bowel from the duodenum to the rectum. Their symptomatology can mimic almost any abdominal disease making diagnosis troublesome. In some circumstances, these cysts can grow to considerable sizes making resection almost impossible since its size can compromise different structures. Surgery is the treatment of choice as complete resection is the only curative treatment. We present a case of a female patient, she suffered from recurrent episodes of abdominal pain mistaken as gastritis. After a profound evaluation, a giant mass in her abdomen was identified and successfully treated. Giant primary mesenteric cyst was the final diagnosis.

Complete Surgical Enucleation of a Giant Chylous Mesenteric Cyst

“…Malignant transformation may occur in 3% of them. Serous cysts usually appear in the distal small bowel or colonic mesentery; chylous cysts appear in the proximal small bowel mesentery, as in the present case; and hemorrhagic cysts are caused by trauma and can appear anywhere in the bowel [10]. Chylous cysts represent 7,3 to 9,9% of all abdominal cysts [2].…”

“…As a consequence, preoperative diagnosis is difficult. Ultrasound, CT scan, and MRI can show the size, the location, the relationship of the cyst to adjacent organs, the thickness of the wall, and the presence of fluid-fluid levels, as a result of an upper fluid level by chyle and a lower fluid level of the lymph [9,10]. The diagnosis is confirmed by the laparotomy findings and the results of the histopathological examination [8].…”

“…Many approaches have been described for the management of mesenteric cysts, such as marsupialization, sclerotherapy, drainage, enucleation, percutaneous aspiration, and en bloc resection of the cyst with the involved adjacent organs (bowel, gallbladder, pancreas, and spleen). Due to high recurrence and infection rates related to marsupialization, drainage, and aspiration, complete surgical (open or laparoscopic) enucleation of the cyst is the treatment of choice [9,10]. In a similar case of a giant chylolymphatic mesenteric cyst [11], the authors emphasize the importance of successful enucleation of the cyst, irrespective of its size, due to its independent blood supply, as opposed to enterogenous cyst.…”

Gastrointestinal sistem kaynaklı konjenital nadir görülen kistik lezyonların histopatolojik değerlendirmesi

“…Çalışma için etik kurul izni alındı. Gastrointestinal [4,5]. Mezenterik kistler, etiyolojileri ve patolojik özellikleri ile altı grupta sınıflandırılmıştır.…”

“…Yaşamı tehdit edici komplikasyonlara nadiren yol açarlar. Kistin tam olarak çıkarılması, malign dönüşüm ihtimali ve tekrarlamasını önlemek için tercih edilmektedir [3,4]. Karında kitle nedeni ile başvuran hastalarda konjenital kistler akılda tutulmalıdır.…”