Sima Romina-Marina, Radosa Julia Caroline, Zamfir Radu, Ionescu Cringu-Antoniu, Carp Delia, Iordache Ioan-Iulian, Stănescu Anca-Daniela, Pleş Liana
Department of Obstetrics Gynecology, Carol Davila University of Medicine and Pharmacy.
St. John Hospital, "Bucur ", Maternity, Bucharest, Romania.
Medicine (Baltimore). 2019 Jul;98(29):e16432. doi: 10.1097/MD.0000000000016432.
Mesenteric cysts are benign gastrointestinal cystic lesions, with an incidence of <1/100 000. They usually develop in the small bowel mesentery, mesocolon (24%), retroperitoneum (14.5%), and very rarely originate from the sigmoid mesentery. Endometriomas represent a localized type of endometriosis and are usually within the ovary. Our case is unique because there are no reports in the literature of endometrial mesenteric cysts.
We present a case of a 29-year-old woman who underwent a routine gynecologic control.
Clinical examination and imaging identified 2 endometriomas on the left and posterior to the uterus.
The patient underwent exploratory laparoscopy. Unexpectedly, a 10 cm mesenteric cyst was identified; this was associated with adhesions in the left adnexal area and a left ovarian endometrioma. The classic surgical approach which was necessary identified the mesenteric cyst with cranial mesosigmoid and ileal adhesions, as well as distal adhesions which included the uterus, ileum, left ovarian endometrioma, left hydrosalpinx, left ureter, and rectum. The cyst was removed completely and a left adnexectomy was performed because of the presence of the endometrioma and adhesions.
The patient's outcome was favorable, with discharge at 72 hours after surgery. The histopathological report revealed that both the mesenteric and ovarian cysts were endometriomas.
Our case is unusual in that a mesenteric cyst was identified in a patient with no clinical symptoms. Furthermore, the histopathological examination revealed the endometriotic origin of the mesenteric cyst which has not previously been reported in the literature.
肠系膜囊肿是良性胃肠道囊性病变，发病率低于1/100000。它们通常发生在小肠系膜、结肠系膜（24%）、腹膜后（14.5%），极少起源于乙状结肠系膜。子宫内膜异位囊肿是子宫内膜异位症的一种局部类型，通常位于卵巢内。我们的病例很独特，因为文献中没有子宫内膜肠系膜囊肿的报道。
我们报告一例29岁女性患者，她接受了常规妇科检查。
临床检查和影像学检查发现子宫左侧及后方有2个子宫内膜异位囊肿。
患者接受了 exploratory laparoscopy（此处原文可能有误，推测为“探查性腹腔镜检查”）。出乎意料的是，发现一个10厘米的肠系膜囊肿；它与左侧附件区粘连及左侧卵巢子宫内膜异位囊肿有关。必要的经典手术方法确定了肠系膜囊肿伴有乙状结肠上段和回肠粘连，以及包括子宫、回肠、左侧卵巢子宫内膜异位囊肿、左侧输卵管积水、左侧输尿管和直肠的远端粘连。囊肿被完全切除，由于存在子宫内膜异位囊肿和粘连，进行了左侧附件切除术。
患者预后良好，术后72小时出院。组织病理学报告显示肠系膜囊肿和卵巢囊肿均为子宫内膜异位囊肿。
我们的病例不同寻常之处在于，在一名没有临床症状的患者中发现了肠系膜囊肿。此外，组织病理学检查显示肠系膜囊肿起源于子宫内膜异位，这在文献中此前未见报道。
