Leigh Rebekah, Sacks Marla A, Won Mitchell M, Mikael Amarseen, Moores Donald, Radulescu Andrei
Loma Linda University School of Medicine, Loma Linda, CA, United States of America.
Division of Pediatric Surgery, Loma Linda University Children's Hospital, Loma Linda, CA, United States of America.
Int J Surg Case Rep. 2021 Dec;89:106566. doi: 10.1016/j.ijscr.2021.106566. Epub 2021 Nov 3.
Pediatric mesenteric cysts, rare and usually benign intra-abdominal tumors, are a difficult preoperative diagnosis due to ambiguous clinical characteristics. The final diagnosis is typically established only during surgery or histological analysis.
An 8-year-old female presented with five days of worsening abdominal pain, associated with nausea, vomiting, and fever, as well as vague tenderness in the right quadrants on examination. Computed tomography imaging showed a 10.5 × 8.7 × 7 cm abdominal mass, most suspicious for a cystic mass of ovarian origin. Upon diagnostic laparoscopy, a mesenteric cyst extending to the root of the mesentery was visualized and entirely resected after conversion to an exploratory laparotomy. Histopathological examination of both the cystic fluid and specimen suggest a benign mesenteric cyst.
Although mesenteric cysts are noticeably rare, it is important differential to consider in pediatric patients with non-specific symptoms like abdominal pain and distention, intestinal obstruction, or a palpable abdominal mass. Notably, these cysts can be managed successfully by complete surgical resection with an excellent outcome.
This report recounts an interesting case of a large mesenteric cyst that mimicked an ovarian cyst in a pre-pubertal girl.
小儿肠系膜囊肿是罕见的腹腔内肿瘤,通常为良性,因其临床特征不明确,术前诊断困难。最终诊断通常仅在手术或组织学分析时才能确立。
一名8岁女性,腹痛加重5天,伴有恶心、呕吐和发热,检查时右下腹有压痛。计算机断层扫描成像显示一个10.5×8.7×7厘米的腹部肿块,最可疑为卵巢来源的囊性肿块。诊断性腹腔镜检查时,发现一个延伸至肠系膜根部的肠系膜囊肿,转为剖腹探查术后将其完全切除。对囊液和标本的组织病理学检查提示为良性肠系膜囊肿。
尽管肠系膜囊肿明显罕见,但对于有腹痛、腹胀、肠梗阻或可触及腹部肿块等非特异性症状的小儿患者,考虑鉴别诊断很重要。值得注意的是,这些囊肿通过完全手术切除可成功治疗,效果良好。
本报告讲述了一例有趣的病例,一名青春期前女孩的大肠系膜囊肿酷似卵巢囊肿。