Asian Journal of Case Reports in Surgery

Mesenteric Cyst as Inguinal Hernia, Should We Do More?

Rosnanadiah M. Y. *

Department of General Surgery, Universiti Kebangsaan Malaysia, Malaysia and Department of General Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia and Unit of Paediatric Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia.

Pavin Bal

Department of General Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia andUnit of Paediatric Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia.

Fatimatuzzahrah B.

Department of General Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia and Unit of Paediatric Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia.

Nazurah J. S.

Department of General Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia.

*Author to whom correspondence should be addressed.

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Abstract

Introduction: Mesenteric cysts are rare cystic structures found in the mesentery of the bowels, spanning from the duodenum to the colon and even into the retroperitoneum. They are infrequently encountered, with incidence rates varying from 1 in 20,000 to 1 in 350,000 hospital admissions. These cysts were first observed in the 16th century and can present with a range of clinical symptoms, from palpable abdominal masses to acute issues. A specific diagnostic feature, known as Tillaux's triad, includes the signs of a central abdomen cystic mass, the mass moving perpendicularly to its origin, and a band of resonance on percussion surrounding the cyst.

Case Report: This report details a case of an incidental finding of a mesenteric cyst that initially presented as an irreducible right inguinal hernia in a one-year-old boy. The cyst was discovered during surgery and required laparotomy, cyst resection, and re-anastomosis of the intestines. Post-surgery, the child recovered well, and histopathology confirmed the diagnosis as a mesenteric cyst.

Conclusion: Mesenteric cysts can have diverse presentations, and they should be considered as a potential cause of inguinal hernias in pediatric patients. Surgical excision with or without bowel resection is the standard treatment with favorable outcomes. The case underscores the importance of considering mesenteric cysts in the differential diagnosis of pediatric inguinal hernias.

Keywords: Mesenteric cysts, inguinal hernias

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References

Tripathy PK, Jena PK, Pattnaik K. Management outcomes of mesenteric cysts in paediatric age group. Afr J Paediatr Surg. 2022 Jan-Mar;19(1):32-35.

Pithawa AK, Bansal AS, Kochar SP. Mesenteric cyst: A rare intra-abdominal tumour. Med J Armed Forces India. 2014 Jan;70(1):79-82.

Dr Khalil Ur Rehman. Mesenteric cyst: A diagnostic dilemma in an emergency. MAR Case

Reports 5.4. Journal of MAR Case Reports. 2022 July;5(4).

Evie Yeap, Ramesh M Nataraja, Maurizio Pacilli. Inguinal hernias in children. Australian

Journal of General Practice; 2020 Jan-Feb.

Fernández Ibieta M, Rojas Ticona J, Martinez Castaño I, Reyes Rios P, Villamil V, Giron Vallejo O, et al. Quistes mesentéricos en la edad pediátrica: ¿quéson en realidad? An Pediatría. 2015;82:e48–51

Ricketts RR. Chapter 89 - Mesenteric and omental cysts. In: Grosfeld JL, O’Neill JA, Coran AG, Fonkalsrud EW, editors. Caldamone AABT-PS (Sixth E), editors. Philadelphia: Mosby; 2006. p. 1399 –406

Pampal A, Yagmurlu A. Successful laparoscopic removal of mesenteric and omental cysts in toddlers: 3 cases with a literature review. J Pediatr Surg. 2012; 47:e5–8.

Memmo L, Belhaj A, Mehdi A. Feasibility of laparoscopic resection of mesenteric cysts: Two case reports. Acta Chir Belg. 2013; 113:43–6.

Solari V, Mullassery D, Lansdale N, Jesudason EC. Laparoscopic excision of a retroperitoneal lymphatic malformation in a newborn. J Pediatr Surg. 2011;46:e15–7.

Weeda VB, Booij KAC, Aronson DC. Mesenteric cystic lymphangioma: a congenital and an acquired anomaly? Two cases and a review of the literature. J Pediatr Surg. 2008;43:1206–8.

de Perrot M, Bründler M, Tötsch M, Mentha G, Morel P. Mesenteric cysts. Toward less confusion? Dig Surg. 2000;17: 323–328

Obaidah A, Mane SB, Dhende N, Acharya H, Thakur A, Arlikar J, Reddy S. Mesentric cyst- an unusual presentation as inguinal hernia. Indian J Surg. 2012 Apr;74(2): 184-5.

Lokavarapu MJ, Huda F, Mahindrakar B Jr, Kumar S, Kumar N. Giant Mesenteric Cyst With Gastric Perforation Masquerading As Obstructed Inguinal Hernia: A Rarest of the Rare Case. Cureus. 2021 Sep 13;13(9): e17919

Vanek VW, Phillips AK. Retroperitoneal, mesenteric, and omental cysts. Arch Surg. 1984;119:838–42.

Prakash A, Agrawal A, Gupta RK, Sanghvi B, Parelkar S. Early management of mesenteric cyst prevents catastrophes: A single centre analysis of 17 cases. Afr J Paediatr Surg. 2010;7:140‑3.

Gafar AM, Batikhe MY. Surgical management for mesenteric cysts in pediatric patients: a single center experience. Int Surg J. 2018;5:1217-21.