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Case Reports
. 2011 Apr-Jun;15(2):264-7.
doi: 10.4293/108680811X13071180406835.

Pre-pubertal presentation of peritoneal inclusion cyst associated with congenital lower extremity venous valve agenesis

Amulya K Saxena  1 , Christoph Castellani, Paola Zaupa, Michael E Höllwarth
Affiliations
Case Reports

Pre-pubertal presentation of peritoneal inclusion cyst associated with congenital lower extremity venous valve agenesis

Amulya K Saxena et al. JSLS. 2011 Apr-Jun.

Abstract

Peritoneal inclusion cysts are uncommon lesions that usually occur in the pelvis of reproductive-age females. The case of a 7-year-old girl with an inflamed peritoneal inclusion cyst with unusual right paracolic localization and congenital lower extremity superficial and deep venous valve agenesis is presented. Inflammation of the peritoneal inclusion cyst was responsible for the signs of acute abdomen and subsequent presentation at our center. The cystic structure was initially diagnosed using ultrasonography, and its complete extent (8cm x 6.5cm x 4cm) was evident after magnetic resonance imaging. The minimal access approach was opted for to resect the entire cyst from the lateral border of the ascending colon. Afterwards, the cyst was punctured to reduce its size and to retrieve the cyst wall using an endoscopic specimen retrieval bag. Minimal access surgery precautions in this patient with congenital lower extremity venous valve agenesis are discussed.

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Figures

Figure 1.
Figure 1.
Magnetic resonance imaging demonstrating the right paracolic localization of the peritoneal inclusion cyst (arrow); axial view (top) and coronal view (bottom).
Figure 2.
Figure 2.
Laparoscopic view of the peritoneal inclusion cyst (arrow) approximated along the lateral border of the cecum (C).
Figure 3.
Figure 3.
The LigaSure device was used to dissect between the plane of the peritoneal inclusion cyst (arrow) and the cecum (C).
Figure 4.
Figure 4.
Severe adhesions were encountered between the peritoneal inclusion cyst and the colon closer to the hepatic flexure obscuring the plane of dissection.
Figure 5.
Figure 5.
The retroperitoneal space (RP) exposed after the cyst resection. The dissection was performed up to the level of the liver (L)/Hepatic flexure along the lateral length of the ascending colon (AC).
See this image and copyright information in PMC

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