Li Xiao-Zhou, Deng Zi-Hao, Deng Xin, Zhang Qing, Wang Jing, Li Tian-Xiong, Du De-Xiao, A-Min Bu-He, Zhao Hao
Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.
Capital Medical University, Beijing, China.
Ann Med Surg (Lond). 2025 Apr 10;87(7):4519-4524. doi: 10.1097/MS9.0000000000003267. eCollection 2025 Jul.
Mesenteric cysts are rare intra-abdominal lesions, with a prevalence of approximately 1 in 100 000 to 1 in 250 000 adults. Clinical presentation can range from asymptomatic to severe. Chylous mesenteric cysts caused by thoracic duct obstruction are particularly rare and have not been previously reported in obese adolescents.
We report the case of a 19-year-old female patient with a rare asymptomatic chylous mesenteric cyst caused by thoracic duct obstruction, which was incidentally discovered during pre-operative evaluation for bariatric surgery. The patient underwent thoracic duct decompression and a personalized low-fat nutrition plan was implemented to mitigate postoperative chyle reflux and address concurrent obesity.
Mesenteric cysts can have variable clinical presentations and their evaluation relies on a range of imaging modalities. Our case highlights the importance of lymphatic system evaluation in the diagnosis and management of mesenteric cysts, particularly chylous cysts. Surgery targeting lymphatic system abnormalities offers a targeted and less invasive treatment strategy than the traditional surgical resection.
This case report emphasizes the importance of imaging evaluation of the lymphatic system for the diagnosis and management of mesenteric cysts. A treatment strategy that combines surgery targeting lymphatic system abnormalities with a personalized nutritional plan can provide a novel and less invasive alternative to traditional surgical resection of chylous mesenteric cysts, addressing the underlying etiology while minimizing surgical trauma and potential complications.
肠系膜囊肿是罕见的腹腔内病变，在成人中的患病率约为十万分之一至二十五万分之一。临床表现可从无症状到严重不等。由胸导管梗阻引起的乳糜性肠系膜囊肿尤为罕见，此前在肥胖青少年中未见报道。
我们报告一例19岁女性患者，患有由胸导管梗阻引起的罕见无症状乳糜性肠系膜囊肿，该囊肿在减肥手术术前评估时偶然发现。患者接受了胸导管减压，并实施了个性化低脂营养计划，以减轻术后乳糜反流并解决并发的肥胖问题。
肠系膜囊肿可有多种临床表现，其评估依赖于一系列影像学检查方法。我们的病例强调了淋巴系统评估在肠系膜囊肿，尤其是乳糜囊肿的诊断和管理中的重要性。针对淋巴系统异常的手术提供了一种比传统手术切除更有针对性且侵入性更小的治疗策略。
本病例报告强调了淋巴系统影像学评估在肠系膜囊肿诊断和管理中的重要性。将针对淋巴系统异常的手术与个性化营养计划相结合的治疗策略，可为乳糜性肠系膜囊肿的传统手术切除提供一种新颖且侵入性更小的替代方法，既能解决潜在病因，又能将手术创伤和潜在并发症降至最低。
