Rattan Kamal Nayan, Nair Vimoj J, Pathak Manish, Kumar Sanjay
Department of Pediatric Surgery, Pt. B.D.Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India.
J Med Case Rep. 2009 Nov 9;3:111. doi: 10.1186/1752-1947-3-111.
Chylolymphatic mesenteric cysts are rare entities with variable presentations and this has surgical implications in the pediatric age group.
We carried out a retrospective analysis of the clinical and histopathological records of pediatric patients diagnosed and treated for chylolymphatic mesenteric cysts at our institute from 1998 to 2008. Eight patients met the histopathological criteria of chylolymphatic mesenteric cyst. These patients were in the age range 18 months to 10 years with a mean age of 4.5 years. Of these eight patients, four presented with an abdominal lump, and two each with abdominal pain and acute intestinal obstruction. On clinical examination, five out of the eight patients had a palpable abdominal mass. Laparotomy and complete excision of the cyst along with the involved gut was performed in all patients. There were no postoperative complications or any recurrence during the follow-up period which ranged from 4 months to 8 years.
Although very rare, chylolymphatic mesenteric cyst should be kept in mind as one of the differential diagnoses of cystic masses of the abdomen including cystic lymphangioma. Ultrasonography and computed tomography suggest the diagnosis but histopathological examination is required for confirmation. Complete excision of the cyst yields excellent results.
乳糜性肠系膜囊肿是罕见的疾病,临床表现多样,这对儿童年龄组的手术治疗具有重要意义。
我们对1998年至2008年在我院诊断和治疗的乳糜性肠系膜囊肿儿科患者的临床和组织病理学记录进行了回顾性分析。8例患者符合乳糜性肠系膜囊肿的组织病理学标准。这些患者年龄在18个月至10岁之间,平均年龄为4.5岁。在这8例患者中,4例表现为腹部肿块,2例分别表现为腹痛和急性肠梗阻。临床检查时,8例患者中有5例可触及腹部肿块。所有患者均行剖腹手术,完整切除囊肿及受累肠段。随访时间为4个月至8年,术后无并发症发生,也无复发。
尽管乳糜性肠系膜囊肿非常罕见,但应将其作为腹部囊性肿块(包括囊性淋巴管瘤)的鉴别诊断之一。超声和计算机断层扫描有助于诊断,但确诊需要组织病理学检查。完整切除囊肿可取得良好效果。