Department of Pediatric Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan.
Surg Today. 2009;39(5):414-7. doi: 10.1007/s00595-008-3854-z. Epub 2009 Apr 30.
Most cases of abdominal lymphangioma are asymptomatic. However, patients may occasionally present with acute abdomen because of an intestinal obstruction or peritonitis caused by infected cysts, hemorrhaging, and/or torsion. These conditions may differ based on the location of the lymphangioma and do not always require emergency surgery. This report presents two cases of abdominal lymphangioma derived from the omentum, which required emergency surgery because of severe abdominal distension and peritonitis caused by torsion, respectively. In contrast, another case of retroperitoneal lymphangioma presented with acute abdomen and underwent elective surgery after conservative therapy for peritonitis. Elective surgery is acceptable if the symptoms are controllable under conservative therapy. However, it is important not to overlook the possible lethal complications such as intestinal and/or urological obstruction, aggressive peritonitis, and torsion of the cyst, which require emergency surgery.
大多数腹部淋巴管瘤是无症状的。然而,患者偶尔会因肠梗阻或感染性囊肿、出血和/或扭转引起的腹膜炎而出现急性腹痛。这些情况可能因淋巴管瘤的位置而异,并非总是需要紧急手术。本报告介绍了两例源自网膜的腹部淋巴管瘤病例,分别因扭转导致严重腹胀和腹膜炎而需要紧急手术。相比之下,另一例腹膜后淋巴管瘤表现为急性腹痛,在腹膜炎保守治疗后行择期手术。如果症状可以通过保守治疗控制,择期手术是可以接受的。然而,重要的是不要忽视可能致命的并发症,如肠和/或尿路梗阻、侵袭性腹膜炎和囊肿扭转,这些并发症需要紧急手术。