Large omental cyst

Abstract

Omental and mesenteric cysts are rare intra-abdominal masses in the pediatric population. When large, these lesions can mimic large-volume ascites and may not be immediately recognized. This can lead to a delay in appropriate treatment as a result of additional unnecessary tests and procedures. We present a case of a large omental cyst in an 18-month-old male with emphasis on imaging findings that can help diagnose this rare, but important entity.

Keywords: CT, computed tomography.

Figure 1

18-month-old male with large omental cyst. Image from patient’s initial ultrasound evaluation shows intraperitoneal multilocular fluid collections.

Figure 2A

18-month-old male with large omental cyst. Axial CT with IV and oral contrast demonstrates a large amount of low-attenuation intra‐abdominal fluid. The mass effect on the bowel and kidney on the left abdomen suggest a cystic mass lesion. The apparently free fluid also present along the liver persuaded the clinicians to evaluate extensively for a cause for ascites.

Figure 2B

18-month-old male with large omental cyst. Coronal CT with IV and oral contrast demonstrates a large amount of low-attenuation intra‐abdominal fluid. The mass effect on the bowel and kidney on the left abdomen suggest a cystic mass lesion. The apparently free fluid also present along the liver persuaded the clinicians to evaluate extensively for a cause for ascites.

Figure 3A

18-month-old male with large omental cyst. Axial CT image performed later in the patient’s course demonstrates mass effect in the left abdomen as well as central bowel displacement.

Figure 3B

18-month-old male with large omental cyst. Coronal CT image performed later in the patient’s course demonstrates mass effect in the left abdomen as well as central bowel displacement.

Figure 4A

18-month-old male with large omental cyst. Ultrasound images again show a multilocular fluid collection in the abdomen.

Figure 4B

18-month-old male with large omental cyst. Ultrasound images again show a multilocular fluid collection in the abdomen with nondependent bowel loops in the right lower quadrant.