小児巨大腸間膜嚢腫の1例

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  • A Case of Huge Mesenteric Cyst in Childhood

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A 14-year-old girl was admitted to our hospital because of an abdominal mass. Physical examination showed abdominal distension associated with fever, general malaise, and dull periumbilical pain. A large elastic hard mass was palpated in the middle abdomen. Laboratory data showed inflammatory reactions. Ultrasonography and CT scan revealed a well-defined, multi-loculated cystic mass occupying almost all of the abdominal cavity. Small intestine was displaced to the right posterior space. In MRI examination, the mass showed hypointensity on T1-weighted image and hyperintensity on T2-weighted image. It was huge mass extending from the left epigastrium to the pelvis. Superior mesenteric artery was displaced to the right. Angiography revealed it was a hypovascular mass, blood supply of which was from the branches of the first jejunal artery. Under the diagnosis of a mesenteric cyst, laparotomy was performed. At laparotomy, we found a huge cystic tumor originating from the jejunal mesentery. The cyst was extirpated completely without resection of the intestine. The cyst mesured 320x190x70mm in size, weighted 3050g, and contained clear and yellow-colored fluid. Pathological diagnosis was cavernous lymphangioma. She is doing well 9 months after the operation with no evidence of recurrence.

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