Yang Min, Xiang Bo, Xie Xiao-Long, Li Ke-Wei, Li Fu-Yu
Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Int J Surg Case Rep. 2020;71:176-178. doi: 10.1016/j.ijscr.2020.04.075. Epub 2020 May 8.
Mesothelial cyst (MC) is very uncommon in clinic, which could occasionally occur in peritoneal, retroperitoneal or even pleural cavity.
We hereby described an infant patient with retroperitoneal MC who was misdiagnosed as congenital choledochal cyst by both radiologists and clinicians. A choledochal cyst resection with hepatojejunostomy under the da Vinci surgical system was routinely prepared for this patient but a local resection for the whole lesion was unexpectedly performed during the operation. The diagnosis of retroperitoneal MC was confirmed by the pathological analysis from surgical specimens.
MC in small size is usually asymptomatic and sometimes detected by imaging examinations which manifests a well-boundary, watery-density and cystic lesion with no enhancement and is often misdiagnosed as lymphangioma or pancreatic pseudocyst. For pediatric patients, MC can occur in the diaphragm and liver in the literature, while retroperitoneal MC around hepatoduodenal ligament for an infant has never been mentioned before. We reported the first case of a retroperitoneal MC around hepatoduodenal ligament for an infant who was preoperatively misdiagnosed as choledochal cyst surgically treated by the da Vinci surgical system.
Retroperitoneal MC around hepatoduodenal ligament should also be considered and resected for an infant.
间皮囊肿（MC）在临床上非常罕见，偶尔可发生于腹膜、腹膜后甚至胸腔。
我们在此描述一名患有腹膜后MC的婴儿患者，该患者被放射科医生和临床医生均误诊为先天性胆总管囊肿。常规为该患者准备了在达芬奇手术系统下行胆总管囊肿切除并肝空肠吻合术，但术中意外地对整个病变进行了局部切除。手术标本的病理分析证实为腹膜后MC。
小尺寸的MC通常无症状，有时通过影像学检查发现，表现为边界清晰、水样密度的囊性病变，无强化，常被误诊为淋巴管瘤或胰腺假性囊肿。对于儿科患者，文献中MC可发生于膈肌和肝脏，而婴儿十二指肠韧带周围的腹膜后MC此前从未被提及。我们报道了首例婴儿十二指肠韧带周围腹膜后MC，术前被误诊为胆总管囊肿，通过达芬奇手术系统进行手术治疗。
对于婴儿，也应考虑十二指肠韧带周围腹膜后MC并进行切除。
