A rare presentation of mesenteric cyst as persistent ascites: A case report

Surgeon. 2024 Apr;22(2):130-132. doi: 10.1016/j.surge.2023.11.013. Epub 2023 Dec 22.

Abstract

Background: Mesenteric cysts have been typically described as cystic lesions of mesentery or omentum occurring either intra-abdominally or in the retroperitoneum. With no typical symptoms, the preoperative diagnosis of mesenteric cyst becomes challenging to establish.

Patient and methods: In this case report, we describe the case of a 29-year-old female who presented with abdominal distension for seven years associated with intermittent constipation. Following complete history, a meticulous physical examination was performed. Laboratory investigations and radiological imaging techniques were used to facilitate the diagnosis which was confirmed on laparotomy.

Results: Physical examination revealed abdominal ascites. Laboratory investigations were unremarkable. Abdominal ultrasound revealed multiloculated massive ascites. A well-defined cystic area 27 × 18cm displacing abdominal viscera was observed on computed tomography (abdomen and pelvis) with contrast medium. Exploratory laparotomy revealed a massive cyst involving almost the entire peritoneal cavity. On histopathology, no signs of malignancy were reported. The post-operative course was excellent, and the patient was discharged following surgery.

Conclusion: As this lesion is rarely considered preoperatively, and the clinical manifestations can be non-specific, we report this case of mesenteric cyst mimicking ascites in order to inform improved decision making among healthcare professionals regarding the timely diagnosis and appropriate management.

Keywords: Ascites; Mesenteric cyst; Peritoneal diseases; Peritoneal neoplasms.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ascites / diagnostic imaging
  • Ascites / etiology
  • Cysts* / surgery
  • Female
  • Humans
  • Mesenteric Cyst* / complications
  • Mesenteric Cyst* / diagnosis
  • Mesenteric Cyst* / surgery
  • Mesentery / diagnostic imaging
  • Physical Examination