Variable Presentations of Mesenteric and Omental Cysts in Infancy and Childhood: Long-Term Follow-Up

Gamal Al-Saied, Mohamed Mahfouz, Omar Al-Samahy, Mohamed Ayob, Mohamed Abdulrazek, Ziyad Alnofei, Riyad Thabet, Mohamed Eshmawy, Arwa Alharthi, Ahmad Alharthi and Ahmad Gamal

Department of Pediatric Surgery, Al-Azhar University, Cairo, Egypt and King Abdul Aziz Specialist Hospital, Taif, KSA

^*Correspondance to: Gamal Al-Saied 

 PDF  Full Text DOI: 10.25107/2474-1647.1725

Abstract

Background/
Purpose: Mesenteric and omental cysts are rare intra-abdominal pathology. Clinical presentation depends on the size of the cyst. Small cysts may be asymptomatic or may present with acute abdomen. The aim of this study is to present a long term study of mesenteric and omental cysts in infancy and childhood with variable presentations.Patients and
Methods: This study was carried out in Al-Azhar University Hospitals, Cairo, Egypt and King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia, in the period from January 2000 through January 2015. The period of follow up was 15 years on average. The study included twenty two cases. Their ages ranged from 7 days to 12 years. 18 (81.8%) patients presented with an abdominal mass without signs consistent with intestinal obstruction and 4 (18.2%) patients presented with acute abdomen. Patients were investigated by abdominal U/S, C.T. scanning and lab studies. Exploratory laparotomy was performed in nineteen patients and assisted laparoscopy for three patients.Results: Out of twenty two cases (14 boys and 8 girls). There were 6 (27.3%) cases of omental cysts and 16 (72.7%) cases of mesenteric cysts. 18 (81.8%) patients presented with abdominal mass without signs of intestinal obstruction and 4 (18.2%) patients presented with acute abdomen due to torsion of the long pedicles of three omental cysts (13.6%) and impaction of the fourth omental cyst (4.5%) in the cavity between the urinary bladder anteriorly and rectum posteriorly. Their cyst wall was partially gangrenous in some areas. Out of 16 (72.7%) cases of mesenteric cysts there were 6 (27.3%) cases with multiple fluid-filled cysts, variable in size, arising from the mesentery of the ileum and the biggest cysts were adjacent to its wall and sharing the same blood supply. 10 (45.5%) cases have had a big, single, fluid-filled cyst with short pedicle arising from the mesentery of the terminal ileum. Transfixation excision of the pedicles was performed in 6 (27.3%) omental cysts and in 9 (40.9%) mesenteric cysts and Ileal resection with a primary end-to-end anastomosis of the ileum in the other 7 (31.8%) mesenteric cysts. Open surgery in 19 (86.4%) cases and assisted laparoscopy in 3 (13.6%) cases. In all cases the postoperative period was uneventful. There was no recurrences or deaths encountered during the follow up period.Conclusion: The mesenteric and omental cysts in infancy and children are rare disease with variable presentations. They always require surgical treatment either open or laparoscopic. There was no evidence of recurrence or deaths during the long-term follow-up period.

Keywords

Mesenteric and omental cysts; Pediatric abdominal cyst

Cite the article

Al-Saied G, Mahfouz M, Al-Samahy O, Ayob M, Abdulrazek M, Alnofei Z, et al. Variable Presentations of Mesenteric and Omental Cysts in Infancy and Childhood: Long-Term Follow-Up. Clin Surg. 2017; 2: 1725.