Giant Mesenteric Cyst With Gastric Perforation Masquerading As Obstructed Inguinal Hernia: A Rarest of the Rare Case

Abstract

Mesenteric cysts are extremely rare intra-abdominal tumors. They usually present with an array of symptoms, usually non-specific, which leads to difficulty in diagnosing them. Occasionally these can present in the emergency as an acute abdomen. We report a rare presentation of a huge mesenteric cyst with gastric perforation, misdiagnosed clinically as obstructed inguinal hernia. A 50-year male presented with complaints of sudden severe pain in the abdomen along with swelling and pain in the right groin region with absolute constipation for the last 4 days. A clinical diagnosis of obstructed inguinal hernia was made. However, on radiological investigations, it was discovered as a giant intra-abdominal cyst herniating into the inguinal canal. On exploration, we were further surprised to find a concomitant gastric perforation.In this case report, we highlight that mesenteric cysts can present as acute abdomen and, very rarely, can be associated with an accompanying cause of surgical abdomen.

Misdiagnosis of vasitis: a potential diagnostic pitfall with computed tomography

“…Amyand’s hernia due to an incarcerated appendix into the inguinal canal [ 19 ] 2. Inguinal herniation of mesenteric fat [ 20 ], hematoma [ 21 ] or cysts [ 22 ]. Compared with the equivocal findings that CT scans may yield in such instances, MRI has higher values on soft tissues so that the tract of the vas deferens can be clearly traced from the seminal vesicle.…”