Chylolymphatic Cyst of Mesentery of Terminal Ileum: A Case Report in 8 Year-old Boy

Abstract

Mesenteric cysts are rare benign intra peritoneal tumor and more than half of the mesenteric cysts involve the mesentery of the terminal ileum. We present 8 year-old boy, who presented with features of acute intestinal obstruction. Ultrasonography (USG) of the abdomen revealed a cystic mass in the peritoneal cavity with dilated loops of bowel. Exploration of the abdomen revealed a solitary cyst of the mesentery of the terminal ileum measured 10 x 8 cm. There was twisting of the part of the ileum (volvulus) due to the cyst. It also involved the wall and lumen of the adjacent ileum and there were dilated bowel loops proximal to the cyst. Complete cyst excision and resection of the part of the ileum involved with the cyst was done en bloc. An ileostomy was created due to gross disparity in the lumen of the ileum, which was closed two and half month later. Histopathology of the excised cyst was consistent with the chylolymphatic cyst (mesenteric cyst).

Keywords: Abdominal cysts; Children; Chylolymphatic cysts; Intestinal obstruction; Mesenteric cysts.

[Table/Fig-1a]:

Operative photograph showing cyst involving the mesentery of the ileum,

[Table/Fig-1b]:

Operative photograph showing mesenteric cyst, volvulus of the ileum, and dilated ileum,

[Table/Fig-2]:

Excised specimen showing mesenteric cyst and part of resected ileum

[Table/Fig-3a]:

Operative photograph showing disparity in the ends of ileal lumen,

[Table/Fig-3b]:

Operative photograph showing an ileostomy and the right para median incision (sutured)

[Table/Fig-4]:

Positive transillumination of the excised mesenteric cyst

[Table/Fig-5]:

Histopathology of the mesenteric cyst (a), resected ileum (b), & mesenteric lymph nodes (c)