Mesenteric and retroperitoneal cysts in children

ABSTRACT

Mesenteric and retroperitoneal cysts are rare intraabdominal lesions of childhood. The purpose of this study was to review our experience with these lesions in order to more clearly define their clinical presentation, diagnosis, and treatment. Eight children were diagnosed and treated for mesenteric cysts [5 patients] and retroperitoneal cystic lymphangiomas [3 patients] The medical records of each child was reviewed as regard to age, sex, clinical presentation, duration of symptoms prior to diagnosis, imaging studies, operative findings, histological features, and outcome. There were 5 boys and 3 girls, their ages ranged from 2 months to 16 years [average age, 40.2 months]. Three patients required emergency surgery and five underwent elective intervention. The main presenting symptoms were abdominal pain and mass. Preoperative ultrasounds were diagnostic for a cystic mass in all patients. The cysts were located in the small bowel mesentery in 3 cases, the base of the mesentery with retroperitoneal extension in 3 cases, and the transverse mesocolon in 2 cases. Operative procedures performed included enucleation of the cyst [4 patients], complete excision with intestinal resection [3 patients], and partial excision, colonic resection-anastomosis and marsupialization in one infant with multiple cysts. No recurrence occurred in this series. Accurate preoperative diagnosis is possible with maintaining a high index of suspicion and the use of ultrasonic imaging and computed tomography [CT]. Retroperitoneal cysts should be considered a different entity from mesenteric cysts even though they present clinically in a similar fashion. Complete cyst resection is the procedure of choice and results in an excellent outcome: