Pediatric chylolymphatic mesenteric cyst - a separate entity from cystic lymphangioma: a case series
Tóm tắt
Chylolymphatic mesenteric cysts are rare entities with variable presentations and this has surgical implications in the pediatric age group. We carried out a retrospective analysis of the clinical and histopathological records of pediatric patients diagnosed and treated for chylolymphatic mesenteric cysts at our institute from 1998 to 2008. Eight patients met the histopathological criteria of chylolymphatic mesenteric cyst. These patients were in the age range 18 months to 10 years with a mean age of 4.5 years. Of these eight patients, four presented with an abdominal lump, and two each with abdominal pain and acute intestinal obstruction. On clinical examination, five out of the eight patients had a palpable abdominal mass. Laparotomy and complete excision of the cyst along with the involved gut was performed in all patients. There were no postoperative complications or any recurrence during the follow-up period which ranged from 4 months to 8 years. Although very rare, chylolymphatic mesenteric cyst should be kept in mind as one of the differential diagnoses of cystic masses of the abdomen including cystic lymphangioma. Ultrasonography and computed tomography suggest the diagnosis but histopathological examination is required for confirmation. Complete excision of the cyst yields excellent results.
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Tài liệu tham khảo
Engel S, Clagett OT, Harrison EG: Chylous cysts of the abdomen. Surgery. 1961, 50: 593-599.
Gupta AR, Nanavati RN, Fernandez AR, Kalgutkar A, Nathani R, Deshmukh SS: Chylous mesenteric cyst: an unusual cause of neonatal intestinal obstruction. Indian Pediatr. 1992, 29 (4): 511-513.
Takiff H, Calabria R, Yin L, Stabile BE: Mesenteric cysts and intra-abdominal cystic lymphangiomas. Arch Surg. 1985, 120 (11): 1266-1269.
Singh S, Baboo ML, Pathak IC: Cystic lymphangioma in children: report of 32 cases including lesions at rare sites. Surgery. 1971, 69 (6): 947-951.
Panjwani K, Gangopadhyay AN, Sharma SP, Gupta DK, Chooramani GS: Chylolymphatic mesenteric cyst: an unusual abdominal mass in a new born. Indian J Pediatr. 1993, 60 (5): 712-714. 10.1007/BF02821744.
Ratan SK, Ratan KN, Kapoor S, Sehgal T: Giant chylolymphatic cyst of the jejunal mesentery in a child: report of a case. Surg Today. 2003, 33 (2): 120-10.1007/s005950300026.
Kriaa S, Hafsa C, Majdoub S, Jouini R, Golli M, Nouri A, Gannouni A: Caecal volvulus with calcified mesenteric cyst. Arch Pediatr. 2007, 14 (7): 924-925. 10.1016/j.arcped.2007.03.036.
Beahrs OH, Judd ES, Dockerty MB: Chylous cysts of the abdomen. Surg Clin North Am. 1950, 30 (4): 1081-1096.
Losanoff JE, Richman BW, El-Sherif A, Rider KD, Jones JW: Mesenteric cystic lymphangioma. J Am Coll Surg. 2003, 196 (4): 598-603. 10.1016/S1072-7515(02)01755-6.
Fujita N, Noda Y, Kobayashi G, Kimura K, Watanabe H, Masu K, Nagano M, Mochizuki F, Yusa S, Yamazaki T: Chylous cyst of the mesentery: US and CT diagnosis. Abdom Imaging. 1995, 20 (3): 259-261. 10.1007/BF00200410.
Phillips GW, Senapati A, Young AE: Chylolymphatic mesenteric cyst: a diagnostic appearance on computer tomography. Br J Radiol. 1988, 61 (725): 413-414. 10.1259/0007-1285-61-725-413.
McEwing R, Hayward C, Furness M: Foetal cystic abdominal masses. Australas Radiol. 2003, 47 (2): 101-110. 10.1046/j.0004-8461.2003.01136.x.
Hebra A, Brown MF, McGeehin KM, Ross AJ: Mesenteric, omental, and retroperitoneal cysts in children: a clinical study of 22 cases. South Med J. 1993, 86 (2): 173-176.
Kurtz RJ, Heimann TM, Holt J, Beck AR: Mesenteric and retroperitoneal cysts. Ann Surg. 1986, 203 (1): 109-112. 10.1097/00000658-198601000-00017.
Vanek VW, Philips AK: Retroperitoneal, mesenteric, and omental cysts. Arch Surg. 1984, 119 (7): 838-842.
Chirathivat S, Shermeta D: Recurrent retroperitoneal mesenteric cyst. A case report and review. Gastrointest Radiol. 1979, 4 (2): 191-193. 10.1007/BF01887522.
Bliss DP, Coffin CM, Bower RJ, Stockmann PT, Ternberg JL: Mesenteric cysts in children. Surgery. 1994, 115 (5): 517-577.
Okur H, Kuchukaydin M, Ozokutan BH, Durak AC, Kazez A, Kose O: Mesenteric, omental and retroperitoneal cysts in children. Eur J Surg. 1997, 163 (9): 673-677.
Raghupathy RK, Krishnamurthy P, Rajamani G, Babuji N, Diriviraj R, Mohan NV, Swamy RN, Gurunathan S, Natarajan M: Intraabdominal cystic swelling in children - laparoscopic approach, our experience. J Indian Assoc Pediatr Surg. 2003, 8: 213-217.
Fish JC, Fair WR, Canby JP: Intestinal obstruction in the newborn: an unusual case due to mesenteric cyst. Arch Surg. 1965, 90: 317-318.