Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients

Abstract

Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman’s colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients.

A rare presentation of a mesenteric venolymphatic malformation with spontaneous hemorrhage in a newborn infant: A case report

“…Fifty percent of cases involve the head and neck and only 5% are intra-abdominal [1][2][3]. Other rare anatomic sites have also been reported including the mediastinum, pleura, lungs, pericardium, and bone [4]. Sixty percent of these tumors are noticed at birth.…”

Sonographic findings in two cases of lymphangioma of the mesocolon in adults

“…Lymphangioma is commonly seen in the head, neck, and axilla, but it can occur anywhere in the body, and abdominal involvement includes the liver, pancreas, spleen, and mesentery . Most cases of lymphangioma of the mesentery occur in children, and presentation in adulthood is relatively rare. Although representing less than 1% of all lymphangiomas, the majority of adult cases of mesenteric lymphangioma reported to date have developed from the small bowel mesentery, and there are very few adult cases of mesocolic lymphangioma in the English literature …”

“…1 Lymphangioma is commonly seen in the head, neck, and axilla, 2 but it can occur anywhere in the body, and abdominal involvement includes the liver, pancreas, spleen, and mesentery. 3,4 Most cases of lymphangioma of the mesentery occur in children, 5,6 and presentation in adulthood is relatively rare.…”