Surgical management for mesenteric cysts in pediatric patients: a single center experience
DOI:
https://doi.org/10.18203/2349-2902.isj20181027Keywords:
Chylolymphatic, Cyst, MesentericAbstract
Background: Mesenteric cysts are exceptional abdominal lesions of childhood. Presentation may vary with broad spectrum of symptoms from asymptomatic mass and nonspecific complaints to an acute abdomen. Objectives of this study were to present a series of patients with mesenteric cysts and to analyze our experience with emphasis on the presentation, management, and outcome.
Methods: This observational study included thirteen children were diagnosed and treated for mesenteric cysts. All cases subjected to clinical evaluation, laboratory investigations and radiological studies. The diagnosis was confirmed on laparotomy. Ethics committee approval was obtained. The main data which extracted and analyzed included demographic data, operative finding, postoperative complications and duration of hospital stay. Data were analyzed using SPSS for Windows software and P value of ≤ 0.05 was considered significant.
Results: There were 13 patients with mesenteric cyst, 5 girls and 8 boys. The ages ranged from neonate to 8 years. Abdominal mass and pain was the main presenting symptoms. Prenatal diagnosis established in two cases. Laparotomy performed in all cases. Small bowel mesentery is the commonest site. Two patients required urgent surgery. Surgical procedures included cyst excision with or without intestinal resection. Chylolymphatic cyst was documented in 4 cases. Post-operative complications reported in 2 cases.
Conclusions: Mesenteric cysts are unusual in children with variable clinical presentation. Complete excision was feasible in nearly all cases, bringing a favorable outcome. The possibility of this disease entity should be considered as the cause of acute abdomen.
References
Chang T, Ricketts R, Abramowsky C, Cotter B, Steelman C, Husain A, et al. Mesenteric cystic masses: a series of 21 pediatric cases and review of the literature. Fetal Pediatr Pathol. 2011;30(1):40-4.
Kurtz R, Heimann T, Holt J, Beck A. Mesenteric and retroperitoneal cysts. Ann Surg. 1986;203:109- 12.
Tan J, Tan K, Chew S. Mesenteric cysts: an institution experience over 14 years and review of literature. World J Surg. 2009;33(9):1961-5.
Bliss D, Coffin C, Bower R, Stockmann P, Ternberg J. Mesenteric cysts in children. Surg 1994;115(5):517-77.
Beahrs O, Judd E, Dockerty M. Chylous cysts of the abdomen. Surg Clin North Am. 1950;30(4):1081- 96.
Richard R. Mesenteric and omental cysts. 6th ed. Pediatric surgery In: Grosfeld JL, O’ Neill JA Jr, Coran AG, Fonkalsrud EW, editors. Philadelphia: Mosby Elsevier; 2006:1399-1406.
Vanek V, Phillips A. Retroperitoneal, mesenteric, and omental cysts. Arch Surg. 1984;119:838-42.
de Perrot M, Brundler M, Totsch M, Mentha G, Morel P. Mesenteric cysts. toward less confusion? Dig Surg. 2000;17:323-8.
Goh B, Tan Y, Ong H, Chui C, Ooi L, Chow P, et al. Intra-abdominal and retroperitoneal lymphangiomas in paediatric and adult patients. World J Surg. 2005;29:837-40.
Advait P, Amit A, Rahul K, Beejal S, Sandesh P. Early management of mesenteric cyst prevents catastrophes: A single centre analysis of 17 cases. Afr J Paed Surg. 2010;7(3):140-3.
Miliaras S, Trygonis S, Papandoniou A, Kalamaras S, Trygonis C. Mesenteric cyst of the descending colon: report of a case. Acta Chir Belg 2006;106(6):714-6.
Walker A, Putnam T. Omental, mesenteric, and retroperitoneal cysts: a clinical study of 33 new cases. Ann Surg. 1973;178:13-9.
Chung M, Brandt M, St-Vil D, Yazbeck S. Mesenteric cyst in children. J Pediatr Surg. 1991;26(11):1306-8.
Kamal N, Vimoj J, Manish P, Sanjay K. Case report Pediatric chylolymphatic mesenteric cyst: a separate entity from cystic lymphangioma: a case series. J Med Case Rep. 2009;3:111.
Egozi E, Ricketts R. Mesenteric Cysts and omental cysts in children. Am Surg. 1997;63(3):28-90.
Liew S, Glenn D, Storey D. Mesenteric Cyst. Aust N Z J Surg. 1994;64(11):741-4.
So Hyun N, Yeon DK, Chul SK, In Koo K. The surgical experience for retroperitoneal, mesenteric and omental cyst in children. J Korean Surg Soc. 2012;83:102-6.
De Perrot M, Bründler M, Tötsch M, Mentha G, Morel P. Mesenteric cysts toward less confusion? Dig Surg. 2000;17:323-8.
Mason J, Soper N, Brunt L. Laparoscopic excision of mesenteric cysts: a report of two cases. Surg Laparosc Endosc Percutan Tech. 2001;11:382-4.
Senocak M, Gündoðdu H, Büyükpamukçu N, Hiçsönmez A. Mesenteric and omental cysts in children: Analysis of nineteen cases. Turk J Pediatr. 1994;36:295-302.
Prosanta K, Himanshu R, Navin R, Debarati C, Rajendra P. Mesenteric cyst: an unusual presentation. Indian J Surg. 2008;70:247-9.
McEwing R, Hayward C, Furness M. Foetal cystic abdominal masses. Australas Radiol. 2003;47(2):101-10.
Durshan A, Gokhan A, Volkan S. Laparoscopic management of mesenteric cyst: a case report. Mount Saint J Med. 2006;73:1019-20.
Raghupathy R, Krishnamurthy P, Rajamani G. Intraabdominal cystic swelling in children: laparoscopic approach, our experience. J Indian Assoc Peditr Surg. 2003;8:213-7.
Kosir M, Sonnino R, Gauderer M. Pediatric abdominal lymphangiomas: a plea for early recognition. J Pediatr Surg. 1991;26:1309-13.
Hancock B, St-Vil D, Luks F, Di Lorenzo M, Blanchard H. Complications of lymphangiomas in children. J Pediatr Surg. 1992;27:220-4.
Hebra A, Brown M, McGeehin K, Ross A. Mesenteric, omental, and retroperitoneal cysts in children: a clinical study of 22 cases. South Med J. 1993; 86(2):173-6.
Chirathivat S, Shermeta D. Recurrent retroperitoneal mesenteric cyst. A case report and review. Gastrointest Radiol. 1979;4(2):191-3.
Steyaert H, Guitard J, Moscovici J, Juricic M, Vaysse P, Juskiewenski S. Abdominal cystic lymphangioma in children: benign lesions that can have a proliferative course. J Pediatr Surg. 1996;31:677-80.
Roisman I, Manny J, Fields S, Shiloni E. Intra-abdominal lymphangioma. Br J Surg. 1989;76:485-9.
Konen O, Rathaus V, Dlugy E, Freud E, Kessler A, Shapiro M, et al. Childhood abdominal cystic lymphangioma. Pediatr Radiol. 2002;32:88-94.
Engel S, Clagett O, Harrison E. Chylous cysts of the abdomen. Surg. 1961;50:593-9.
Losanoff J, Richman B, El-Sherif A, Rider K, Jones J. Mesenteric cystic lymphangioma. J Am Coll Surg. 2003;196(4):598-603.
Gupta A, Nanavati R, Fernandez A, Kalgutkar A, Nathani R, Deshmukh S. Chylous mesenteric cyst: an unusual cause of neonatal intestinal obstruction. Indian Pediatr. 1992;29(4):511-3.
Takiff H, Calabria R, Yin L, Stabile B. Mesenteric cysts and intraabdominal cystic lymphangiomas. Arch Surg. 1985;120(11):1266-9.
Fish J, Fair W, Canby J. Intestinal obstruction in the newborn: an unusual case due to mesenteric cyst. Arch Surg. 1965;90:317-8.
