Mesenteric Cyst in a 5-Year-Old Child with Partial abdominal Obstruction: Case Report from Bahrain

Mesenteric cysts are rare, variably-sized intra-abdominal lesions developing during childhood. Their symptoms vary from being asymptomatic and incidentally found to non-specific, presenting as lower abdominal pain, nausea and vomiting, constipation and diarrhea. Clinically, these abdominal masses may be palpable in more than 50% of patients. The diagnosis of these lesions can be made accurately radiologically through abdominal ultrasound and CT. The treatment of choice is complete surgical resection. Hereby we report the clinical course of a 5 year old child with a mesenteric cyst who complained of acute abdominal pain, constipation and vomiting and were surgically treated after being diagnosed with a mesenteric cyst based on radiological examination.

Mesenteric cyst detection and segmentation by multiple K-means clustering and iterative Gaussian filtering

<span lang="EN-US">In this article a fully automated machine-vision technique for the detection and segmentation of mesenteric cysts in computed tomography (CT) images of the abdominal space is presented. The proposed technique involves clustering, filtering, morphological operations and evaluation processes to detect and segment mesenteric cysts in the abdomen regardless of their texture variation and location with respect to other surrounding abdominal organs. The technique is comprised of various processing phases, which include K-means clustering, iterative Gaussian filtering, and an evaluation of the segmented regions using area-normalized histograms and Euclidean distances. The technique was tested using 65 different abdominal CT scan images. The results showed that the technique was able to detect and segment mesenteric cysts and achieved 99.31%, 98.44%, 99.84%, 98.86% and 99.63% for precision, recall, specificity, dice score coefficient and accuracy respectively as quantitative performance measures which indicate very high segmentation accuracy.</span>

A huge mesenteric teratoma in reproductive age woman: a case report

The incidence of dermoid ovarian cyst is 15-20% of all ovarian neoplasm, which is a common entity. Mesenteric cyst are one of the very rare entities with incidence of 1 in 2, 50, 000. Dermoid cysts rarely present as mesenteric cysts. Mesenteric dermoid cyst have good prognosis. Here, we report a rare abdominal tumor which was initially diagnosed clinically as an ovarian dermoid cyst but operative and histology revealed it to be mesenteric dermoid cyst. A 36 year-old, multiparous presented with abdominal mass, gradually increasing in size since 1 year with recent onset of abdominal pain. Physical examination revealed abdominal mass of 22×20 cm size, globular, non-tender, mobile, and cystic to solid in consistency. Contrast-enhanced computed tomography (CECT) showed 23×21×14.4 cm heterogeneous enhancing mass lesion with areas of fat density and calcifications within, suggestive of neoplastic mass lesion, likely teratoma. Tumor markers were within normal limit. Patient was managed surgically. Laparotomy findings revealed a huge solid mesenteric mass (22×20 cm) weighing 6.5 kgs. Histopathology showed mature cartilage, osteoid formation, fibro-adipose connective tissue, focal lymphoid aggregates, congested blood vessels and focal mature neuronal component and no immature elements seen, confirming dermoid cyst. Mesenteric cyst are rare intra-abdominal tumor found most commonly in ileum (60%) next is ascending colon (40%). However, if a mesenteric cyst locates within the pelvic cavity, as in this case, it may be misdiagnosed as an ovarian cyst.

ELECTIVE REMOVAL OF A LARGE MESENTERIC CYST – LAPROSCOPIC EXCISION.

A mesentric cyst is a rare intra abdominal benign pathology. They are found in the mesentry of small bowel (66%) and large intestine (33%), usually in the right colon. Very few cases have been reported of tumours found in mesentry of descending colon, sigmoid or rectum. Mesentric cysts do not show classical clinical findings and are detected incidentally during imaging due to absent or non-specific clinical presentation or during management of one of their complications. Optimal surgical management requires complete excision of the lesions. Although they are invariably benign, a full laparotomy has been the conventional approach for resection, often via a large midline incision. The advantage of minimally invasive surgery has allowed resection of the cysts, without need for a full laparotomy, with the benefit of improved cosmetics, less postoperative pain, and shorter hospital stay. However, laparoscopy can be technically challenging with large intra abdominal cysts. This is mainly due to lack of intra abdominal space and poor ergonomics in relation to port placements with large cysts. We report the incident of a 44-year-old female. A USG and computed tomography scan followed to help diagnose the lesion as a cyst. She underwent laproscopic removal and the cyst was enucleated intact. Postoperative period was uneventful and pathological examination showed a benign mesentric cyst . Objectives of this study is to analyze our experience with emphasis on the presentation, management, and outcome. Laproscopy not only helps in diagnosing the site and origin of the mesentric cyst but also has a therapeutic role. Laproscopic treatment of mesentric cyst is a safe, preferred method of treatment and is a less-invasive surgical technique. Here, we present an unusual case of mesentric cyst arising from Ascending colon treated by laproscopic excision.

EP.TH.697The great mimic of mesenteric cyst - an interesting case report of mucinous adenocarcinoma of the ovary

Aims A mesenteric cyst, rare intra-abdominal pathology, poses a clinical challenge due to lack of pathognomonic symptoms, variability in presentation and location. We present an interesting case with a significant diagnostic dilemma; a suspected benign ovarian cyst invading the mesentery on repeat imaging and laparoscopy is questioned for mesenteric in origin. Methods A 77-year-old female presented with a 6-year history of abdominal mass. She had multiple radiological scans which reported it as a simple cyst, but the origin could not be defined. She had repeated aspirations with benign cytology. They cyst developed septations, filled-up rapidly, became an abdominal cyst from the pelvis. A careful decision was taken for surgery. The procedure undertook with general surgeons and gynaecologists with a possibility of the mesenteric cyst. During laparotomy, the cyst was found extending from pelvis and base of mesentery up to the diaphragm densely adhered to sigmoid colon. The cyst was completely excised with hysterectomy and oophorectomy. Results The patient recovered well from surgery. Post-operatively, histopathology confirmed Figo IC2 Grade 2 mucinous adenocarcinoma of the ovary with an expansive growth pattern. She is awaiting further treatment with chemotherapy after discussion in the Gynaecology MDT. Conclusion This case emphasises the importance of having an insight into the question of established diagnosis in the face of a changing clinical picture. Also, it highlights the need for understanding the mesenteric cyst. Early exploration can prevent diagnostic delays and further treatment.