Laparoscopic Treatment of a Huge Mesenteric Chylous Cyst

Mesenteric chylous cysts are rare pathologic entities that often present with unspecific symptoms. The preoperative diagnosis requires all the common abdominal imaging techniques, but usually the correct diagnosis may be made only at the operation stage or during the histological examination. The treatment of choice is the complete surgical excision that may be safely performed by laparoscopy. A 58-year-old man underwent laparoscopic excision of a huge mesenteric chylous cyst. The technique entails the perfect control of the major abdominal vessels running near the tumor and the complete sealing of the chylous and blood vessels to and from the cyst.     

A Chylous Cyst of the Mesentery: Report of a Case

(Received for publication on Oct. 21, 1998; accepted on July 13, 1999)     

Mesenteric Cyst of the Descending Colon: Report of a Case

Mesenteric cysts are rare benign, lesions that are discovered accidentally or during the management of one of their complications (torsion, rupture, haemorrhage, obstruction of nearby organs). We present the case of a 56-year old female patient, with a mesenteric cyst of the descending colon, discovered accidentally during a routine gynaecological examination. Preoperative evaluation included U/S scan, IVP, CT scan and MRI scan. She underwent exploratory laparotomy and the cyst was enucleated intact. Postoperative period was uneventful and pathological examination showed a benign mesenteric lymphangioma. The patient is free of symptoms on 1-year follow-up. We also review the literature.     

Strangulated Umbilical Hernia Including a Mesenteric Cyst: a Rare Cause of Acute Abdomen

Mesenteric cysts are rare intra-abdominal lesions. They are usually diagnosed as an incidental laparotomy finding in adults but in childhood, they may present with acute abdomen.

In this report, a 72-year old female was referred to our hospital, suffering from acute abdominal pain, several episodes of nausea and vomiting. Clinical abdominal examination revealed an irreducible recurrent umbilical hernia. The patient had both muscular defense and abdominal tenderness. Plain abdominal radiography showed multiple air-fluid levels. With these findings, a diagnosis of acute abdominal pathology was accepted and an urgent laparotomy was performed. A 5-cm-diameter mesenteric cyst was excised from the mesentery of the proximal jejunum and a prosthetic mesh was placed for incisional hernia. This is the first report of a strangulated umbilical hernia complicated with a mesenteric cyst.     

Chylous metrorrhagia

Insufficiency of the cisterna chyli may result in chyloperitoneum, chyluria, chyloedema of the lower limbs and rarest of all--chylous metrorrhagia. One case of the latter complication is fully described and one other briefly mentioned. Both were treated by excision of all the dilated lymphatics around the vena cava and iliac veins with good results. Both cases showed lacunae in the flat bones which may be related to the lymphatic dysplasia.     

乳糜腹水

乳糜腹水在临床少见 ,发生的原因主要有先天性淋巴管异常、外伤等影响淋巴液正常回流的各种病变。依据穿刺腹水液的理化分析作出诊断并不困难 ,但要明确病因有时很不容易。除针对原发病外 ,治疗以饮食调理和手术为主。     

Chylous mesenteric cysts in children

Purpose  

To evaluate the clinical features, diagnosis, and treatment of chylous mesenteric cysts (CMCs) in children.