Ling J H, Chou Y H, Tiu C M, Yeh T J, Wei C F
Department of Radiology, Veterans General Hospital, Taipei.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Mar;47(3):213-7.
Mesenteric cyst is defined as a cystic mass located in the mesentery, and has rarely been reported. Before the clinical use of ultrasound (US), the imaging diagnosis of the abdominal mass depended on plain X-ray films and contrast examinations to delineate the space occupying lesion. The later use of US enables us to readily identify mass character. For example, whether it is cystic or solid, with or without septum, or whether there is sediment in the cyst. US examination is the method of choice in evaluating abdominal masses. Two cases of pediatric mesenteric cysts were brought to our hospital on account of complication. US of the first patient revealed a huge cystic mass with sediment and septae in central abdomen. Mild hydronephrotic change of the right kidney was found. The pathology showed nonepithelial lining multiloculated cyst surrounded by a thick, fibrotic granulomatous wall with suppurative cell infiltration and some calcifications. The histopathological diagnosis was an infected pseudocyst. The other patient had a cyst which twisted the jejunum and resulted in intestinal obstruction. US found dilated intestinal loops and a septate cystic mass in epigastrium. The pathology showed a multiloculated cyst with mesothelial lining, representing a mesothelial cyst. Both patients were treated surgically and had an uneventful recovery. In this article we described and explained the findings on US, discussed the differential diagnoses and compared different imaging modalities.
肠系膜囊肿被定义为位于肠系膜的囊性肿块,鲜有报道。在超声(US)临床应用之前,腹部肿块的影像学诊断依赖于普通X线片和造影检查来勾勒占位性病变。后来US的应用使我们能够轻松识别肿块特征。例如,它是囊性还是实性,有无隔膜,或者囊肿内是否有沉积物。US检查是评估腹部肿块的首选方法。我院收治了两例因并发症前来就诊的小儿肠系膜囊肿病例。首例患者的US检查显示中腹部有一个巨大的囊性肿块,内有沉积物和隔膜。右肾有轻度肾盂积水改变。病理显示为无上皮衬里的多房囊肿,周围是增厚的纤维化肉芽肿性壁,有化脓性细胞浸润和一些钙化。组织病理学诊断为感染性假性囊肿。另一例患者的囊肿扭转了空肠,导致肠梗阻。US检查发现肠袢扩张,上腹部有一个有隔膜的囊性肿块。病理显示为有间皮衬里的多房囊肿,为间皮囊肿。两名患者均接受了手术治疗,恢复顺利。在本文中,我们描述并解释了US检查结果,讨论了鉴别诊断,并比较了不同的影像学检查方法。