Quistes mesentéricos en la edad pediátrica: ¿qué son en realidad? / Mesenteric cysts in children

OBJETIVOS: Los quistes mesentéricos (QM) son tumores quísticos benignos, integrados en el tejido del mesenterio o del epiplón. Hemos revisado los casos de QM no enterógeno. MATERIAL Y MÉTODOS: Revisión de historias clínicas y biopsias de los casos intervenidos de QM en el periodo 2002-2012. RESULTADOS: Encontramos a 7 pacientes, edad media de 5,3 a˜nos (rango 3-11). El diagnóstico fue ecográfico en todos, salvo en uno. Todos presentaron dolor abdominal; 5 (71,4%) vómitos; 4 (57%) distensión abdominal; 3 (42,8%) fiebre; ninguno presentó obstrucción abdominal completa, aunque 2 pacientes (28,6%) presentaron suboclusión. El quiste fue pediculado o sésil en todos menos en uno, que englobaba raíz de mesocolon y retroperitoneo. La histología de todos ellos reveló malformación linfática. No hubo recurrencias. CONCLUSIONES: Los quistes mesentéricos en niños son en su mayoría malformaciones linfáticas del mesenterio, con clínica muy variada. En el 50-60% están integrados en el mesenterio y requieren resección del asa afectada y anastomosis

OBJECTIVES: Mesenteric cysts (MC) are benign cystic tumors that grow within mesentery or omentum tissue. We have reviewed the cases of MC reported and operated on in our centre. MATERIAL AND METHODS: Retrospective review of clinical records of MC cases during the period 2002-2012 RESULTS: A total of 7 patients were found. Mean age was 5.3 years (range 3-11). Abdominal ultrasound was the diagnostic tool in all cases, except for one, which was diagnosed during laparotomy. All presented abdominal pain, 5 (71.4%) vomiting, 4 (57%) gross abdominal distension, 3 (42.8%) fever, and none presented complete abdominal obstruction, although 2 patients (28.6%) had slight sub-occlusion symptoms. All MC were pedicled or sesil, except for our last case, which extended into the retroperitoneum. All specimens were reported as Limphatic Malformation. None recurred. CONCLUSIONS: MC in children are mostly Lymphatic Malformations of mesentery or omentum origin, and clinical presentation varies from chronic abdominal pain to sudden-onset peritonitis or volvulus. About 50-60% require intestinal resection and anastomosis

Mesenteric cystic lymphangioma: a congenital and an acquired anomaly? Two cases and a review of the literature.

Mesenteric cystic lymphangioma is an uncommon benign abdominal mass. Two cases of mesenteric cystic lymphangioma are presented, both in combination with malrotation and intermittent volvulus. Both mesenteric cystic lymphangiomas were located near the duodenojejunal junction, the usual area of torsion in case of a volvulus. These findings suggest that mesenteric cystic lymphangioma could have evolved as a consequence of chronic intermittent volvulus. We hypothesize that in patients with malrotation and volvulus, mesenteric cystic lymphangioma may be regarded as an acquired anomaly.

Complicated duplication cysts on the ileum presenting with a mesenteric inflammatory mass.

Mesenteric inflammation caused by complicated duplication cysts rarely occurs. We present and discuss the imaging findings of a mesenteric inflammatory mass caused by complicated duplication cysts in an infant. Sonography showed a complex, echogenic cystic mass occupying the right subhepatic region containing two thick-walled cystic lesions inseparable from the normal bowel loop. On CT images a large, heterogeneously enhancing, hypodense peritoneal mass was observed to infiltrate the mesentery, which contained small cystic masses with enhancing thick walls. At surgery a mesenteric inflammatory mass caused by two complicated duplication cysts was found to be firmly fixed by surface contact with the ileum. A review of the literature relating to the etiologic relationship between a mesenteric inflammatory mass and complicated duplication cysts is presented.

Renal failure as a result of mesenteric cyst.

The authors report a rare case of renal failure secondary to abdominal cyst in a newborn girl. The clinical presentation was one of a largely distended abdomen coupled with anuria. The histopathologic and clinical findings suggest mesenteric cyst causing renal failure by mass effect.

Isolated enteric duplication cysts.

Two rare cases of completely isolated duplication cysts are reported. A large but asymptomatic tubular cyst hanging from a narrow pedicle arising from the base of the terminal ileal mesentery was removed in a 6-day-old boy along with correction of associated malrotation. Multiple isolated duplication cysts located in the thorax and abdomen were excised in a 10-week-old infant. Both children remained asymptomatic after surgery.

Metastatic adenocarcinoma arising from a small bowel duplication cyst.

A case report of adenocarcinoma arising from a small bowel mesenteric cyst is presented. A discussion and review of the relevant literature then follows.

Newborn intraabdominal cystic lymphatic malformations.

Cystic lymphatic malformations are rare causes of abdominal masses in the newborn. Also known as mesenteric, omental, or retroperitoneal cysts, they can present in a variety of ways including, intestinal obstruction, volvulus, nonspecific abdominal pain, intracystic hemorrhage, or as an asymptomatic abdominal mass. Abdominal ultrasound scan provides a definitive diagnosis in most suspected cases. Complete resection is possible in most patients except those with extensive retroperitoneal involvement. Recurrence is unusual when complete resection is accomplished. Because most case series with complete data suggest that these entities are lymphatic malformations, the authors suggest the more specific term, cystic lymphatic malformations, be used to describe these lesions.

Sudden death in children due to mesenteric defect and mesenteric cyst.

Two cases of sudden death in young female children due to small intestinal volvulus are reported, which involved a mesenteric defect and a mesenteric cyst. Death due to small intestinal volvulus is uncommon, especially when complicated by either a mesenteric defect or cyst.