Yadav Krishna Kumar, Acharya Kshitiz, Yadav Chitrasen, Yadav Rupesh Kumar, Koirala Dinesh Prasad, Dahal Geha Raj
Pediatric Surgery Unit, Department of General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal.
Int J Surg Case Rep. 2024 Apr;117:109480. doi: 10.1016/j.ijscr.2024.109480. Epub 2024 Mar 6.
Mesenteric cysts are the rare benign intraperitoneal tumor, which are common in the mesentery of the terminal ileum. Though mesenteric cysts are frequently seen, chylolymphatic mesenteric cysts in children are rare entities.
Our case is a case of a 3-year-old female child presenting to our center with a complain of abdominal pain. Ultrasonography (USG) of the abdomen revealed a cystic lesion in the right upper abdomen, and computed tomography (CT) scan showed a large homogenous fluid density lesion in the right upper abdomen, giving a provisional diagnosis of mesenteric cyst. She was managed surgically: the cyst was excised, the involved segment of bowel was resected and the remaining was anastomosed. On histopathology, the final diagnosis of a chylolymphatic mesenteric cyst was made.
Clinical presentations may vary from asymptomatic abdominal lump to features of acute abdomen. Imaging modalities like ultrasonography and computed tomography scans are the mainstay of investigations. Surgical management with excision of cyst, and resection of the involved bowel segment is the treatment of choice, as done in our patient. The final diagnosis is made after the histopathologic examination of the excised specimen.
Chylolymphatic mesenteric cysts are rare, and have varied clinical presentations. Although rare, chylolymphatic mesenteric cysts should be considered a differential diagnosis in patients presenting with cystic masses in the abdomen.
肠系膜囊肿是一种罕见的良性腹膜内肿瘤,常见于回肠末端系膜。尽管肠系膜囊肿较为常见,但儿童乳糜性肠系膜囊肿却较为罕见。
我们的病例是一名3岁女童,因腹痛前来我院就诊。腹部超声检查(USG)显示右上腹有一个囊性病变,计算机断层扫描(CT)显示右上腹有一个巨大的均匀液体密度病变,初步诊断为肠系膜囊肿。她接受了手术治疗:切除囊肿,切除受累肠段并进行剩余肠段吻合。组织病理学检查最终确诊为乳糜性肠系膜囊肿。
临床表现可能从无症状腹部肿块到急腹症表现不等。超声检查和计算机断层扫描等影像学检查是主要的诊断手段。如我们的患者一样,手术切除囊肿并切除受累肠段是首选治疗方法。最终诊断需在切除标本的组织病理学检查后确定。
乳糜性肠系膜囊肿罕见,临床表现多样。尽管罕见,但对于腹部出现囊性肿块的患者,应考虑乳糜性肠系膜囊肿作为鉴别诊断之一。