Congenital mesenteric cysts: rare but important entities in abdominal surgery

Abstract

Mesenteric cysts are rare, benign, intra-abdominal tumors with an incidence of 1 case per 2,50,000 hospital admission. They present with non-specific clinical symptoms and signs which mostly lead to misdiagnosis. In many conditions mesenteric cysts are discovered either accidentally during radiological examination or during laparotomy for management of complications. Mesenteric cysts are usually non-cancerous and can be lined by different kinds of tissues. The exact cause of mesenteric cysts is not known, but there are various theories regarding it. In children they are considered as congenital i.e., due to abnormalities in development of embryonic mesentery and in adults it might be due to lymphatic malformation, occult trauma or infection. Treatment of mesenteric cyst includes enucleation or surgical excision depending on type of cyst. Since the case is very rare, pre-operative diagnosis and treatment is a challenge. We report a case of five-year-old female child with enterogenous mesenteric cyst in the small intestine. The differentials of ultrasound showed para ovarian cyst or mesenteric cyst. Abdominal computed tomography (CT) revealed an attached cystic mass at mesentery measuring 96×28×17 mm (CC×AP×AR). The child underwent exploratory laparotomy with cyst excision and intestinal resection with end-to-end anastomosis of small intestine. The knowledge about these cysts is important because many times they go undiagnosed and cause serious complications like rupture, torsion or intestinal obstruction.