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. 2022 Aug:97:107402.
doi: 10.1016/j.ijscr.2022.107402. Epub 2022 Jul 9.

Idiopathic lymphatic mesenteric cyst of the proximal jejunum: A case report of an unusual clinical presentation

Michele Ghielmetti  1 , Kerstin J Neuschütz  1 , Anna Hirschmann  2 , Katharina Marston  3 , Daniel C Steinemann  1 , Marco von Strauss Und Torney  4
Affiliations

Idiopathic lymphatic mesenteric cyst of the proximal jejunum: A case report of an unusual clinical presentation

Michele Ghielmetti et al. Int J Surg Case Rep. 2022 Aug.

Abstract

Introduction: Mesenteric cysts are rare lesions of the abdominal cavity or retroperitoneum. The exact etiopathogenesis is still undefined. Clinical manifestation can vary from asymptomatic patients to symptoms of an acute abdomen, making diagnosis very challenging.

Case presentation: We present a case of a 47-year-old male with new ongoing polyuria and nocturia as well as episodes of slight abdominal pain. An abdominal ultrasound showed ascites and the computer tomography (CT) scan raised suspicion of an internal hernia. We performed a diagnostic laparoscopy and open resection of a cystic lesion of the small bowel mesentery. The histological examination revealed a lymphatic mesenteric cyst.

Discussion: Mesenteric cysts represent rare intra-abdominal tumors that physicians should consider as a differential diagnosis in patients with abdominal pain and an intra-abdominal mass.

Conclusion: Surgery should be advised to prevent the development of complications and to confirm the histopathological diagnosis.

Keywords: Chylous mesenteric cyst; General surgery; Laparoscopy; Lymphatic mesenteric cyst; Mesenteric cyst.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
A + B: Axial (A) and coronal (B) enhanced CT images show localized fluid in the right lower abdominal quadrant (arrowheads in A and B) with a solitary calcification (arrow in A). The proximal slightly fluid-distended jejunal intestine loop (arrows in B) has an atypical straight orientation towards the right lower abdomen with swirling mesentery vessels suspicious for an internal hernia.
Fig. 2
Fig. 2
Macroscopic image of the lymphatic mesenteric cyst (pathological specimen).
Fig. 3
Fig. 3
Microscopic image of the lymphatic mesenteric cyst.
See this image and copyright information in PMC

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