November 2017 Vol. 5 No.11

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Original Research Article

Intra-abdominal Cystic Lymphangiomas and Mesenteric Cysts and Methods of Excision

^*Ghada Morshed Ahmed Morshed MD, MRCS and Nader Shaaban Zaki MD

Assistant professors of general and Laparoscopic Surgery, Department of Surgery, Faculty of Medicine Fayoum University, Egypt

*Corresponding Author’s E-mail: ghadamorshed@yahoo.com
Tel.: 01225870476

Accepted November 19, 2017

Abstract

Intra-abdominal cystic lymphangiomas and mesenteric cysts are uncommon and clinically confusing lesions, histopathologic evidence suggests that they are pathologically different. So these lesions must be differentiated, because lymphangiomas are more relapsing and invasive than mesenteric cysts. The aim of the study is to discuss the different methods of excision of these cysts and to detect the histologic difference between them. The study is retrospective study included twelve patients and performed in El Fayoum University Hospital during the period from December 2013 to September 2017. All Patients were children between (5 to 12 years). Provisional diagnosis depended on patients’ evaluation after complete clinical examination, laboratory, radiological investigations and final diagnosis was reached after excision and histopathological examination. Eleven Patients were admitted with abdominal pain, 1 with abdominal distension and constipation, 11 cases with abdominal mass, one case with small intestinal obstruction and tenderness. Plain x-ray erect, abdominal ultrasound and CT scan with intravenous contrast were diagnostic in 10 patients, 2 patients were diagnosed after exploration. Mesenteric cyst was found in mesentery of small intestinal in 10 cases and 2 were in the greater omentum. Complete excision was done laparoscopically in 2 patients and with open laparotomy in 10 patients. Histopathological examination revealed cystic lymphangiomatous tissue with no malignant features in 3 patient and mesenteric cysts lined by endothelium in nine patients with no malignant features. Intra abdominal mesenteric and lymphangiomatous cysts can be completely excised by laparoscopy. Histologic evidence suggests that intra-abdominal cystic lymphangiomas and mesenteric cysts are pathologically different, so these lesions must be differentiated because lymphangiomas are more relapsing and invasive than mesenteric cysts.

Keywords: Mesenteric cyst, lymphangiomatous cysts, Laparoscopy