Huge Mesenteric Cystic Lymphangioma Presenting with Small Bowel Volvulus in a 3-Year-Old Child
Hatim Jabri *
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Mahamat Saleh Mahamat
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Ayoub Khaled
Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco and Department of Radiology, Hassan II University Hospital, Fez, Morocco.
Naoufal Boumahdi
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Othmane Alaoui
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Abdelhalim Mahmoudi
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Khalid Khattala
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Youssef Bouabdallah
Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco and Faculty of Medicine Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Mesenteric cystic lymphangioma is a rare abdominal mass. Small bowel volvulus caused by mesenteric lymphangioma is exceptional but potentially fatal. We report a case of a 3-year-old boy who complained of recurrent abdominal pain for several months and was admitted to the emergency department for acute abdominal pain with vomiting and bowel obstruction over 24 hours. Clinical examination objectified a peri-umbilical pain. Radiological investigations objectified a small bowel volvulus with individualization of a cystic lesion. Surgical exploration revealed a huge cystic lymphangioma of the mesentery, with a small bowel volvulus over completed common mesentery. The cystic lymphangioma was excised with the 2 supporting bowels, and an ileo-ileal anastomosis was performed. Histological findings confirmed the diagnosis. The child remained asymptomatic at the 6-month follow-up; no recurrence had been noted.
Keywords: Small bowel volvulus, mesenteric lymphangioma, abdominal pain, surgical resection