Omental and Mesenteric Cysts in Children

Abstract

. Six children with omental or mesenteric cysts are reported. The cysts usually gave rise to an uncharacteristic clinical picture and deceptive findings, which lead to misconception of the nature of the lesions. The primary step to correct diagnosis is to include the disease among the differential possibilities; ultrasonography may offer conclusive information.

Mesenteric cystic lymphangioma

“…The severity of symptoms is dependent on size, location and possible complications of the lesion such as rupture, torsion, infection or hemorrhage. 5,8 This is reflected well in both our cases (Figures 1 & 2). This lesion, as we have seen, often gives rise to non-specific symptoms and deceptive signs, which frequently cause diagnostic dilemmas, and exposes the patient to unnecessary investigations.…”

“…3 However, substantial overlap in the imaging findings of the different abdominal cystic lesions may result in confusing cystic lymphangioma with ovarian cysts, intestinal duplication, and necrotic tumors of smooth muscle such as leiomyoma and leiomyosarcoma, cystic mesothelioma and cystic teratoma, lymphoma and retroperitoneal cysts. 3,5,8,9 In our first case the mode of presentation left no doubt about the diagnosis of perforated appendicitis and none of the said diagnostic tools has been considered.…”

“…The accurate diagnosis has rarely been made ahead of the operation in the era before U/S. 8 Plain radiographs, barium studies and intravenous pyelography may demonstrate displacement of the alimentary, urinary tract, or both and other non-specific radiological signs, but the so yielded information is of little value for making a precise diagnosis. Ultrasonography and CT are deemed the diagnostic tools of choice.…”

“…Acute appendicitis, intussusception and ovarian cysts were the most frequent erroneous diagnosis reported. 5,8 At laparotomy, cystic lymphangioma can be suspected by its gross appearance. It is often intimately attached to the intestinal wall, multiple and multilocular.…”

Omental pseudocyst

“…1,2 Because of its rarity, the diagnostic image and clinical features are still not fully understood. We present a case of a 29-year-old man with an omental cyst.…”