Rare mesenteric cystic lymphangioma presenting as acute intestinal obstruction in a 10-year-old boy

Abstract

A 10-year-old previously healthy boy with no prior surgical history presented with three days of generalized abdominal pain, nausea, and emesis. Physical exam revealed a diffusely tender and distended abdomen with pain out of proportion to exam. Abdominal x-ray revealed findings consistent with small bowel obstruction. He underwent emergent abdominal exploration finding a volvulized portion of small bowel due to a small bowel mass. A 25cm × 18 cm mass associated with small bowel was removed and small bowel anastomosis performed. Post-operative pathology revealed a mesenteric cystic lymphangioma. The patient was subsequently discharged without post-operative complications to date. A review of the literature revealed less than 200 reported cases of mesenteric cystic lymphangioma. We encourage accurate reporting of this unique pathology for the benefit of surgical work-up and planning, epidemiologic tracking and outcomes.

Keywords

• Pediatric surgery
• Pediatrics
• Surgery
• Mesenteric cystic lymphangioma
• Cystic malformations