WOFAPS 2025 8th World Congress of Pediatric Surgery

Arije Zouaoui, Fatma Thamri, Yosra Kerkeni, Skander Smaoui, Riadh Jouini

Pediatric Surgery Department, Children's Hospital Bechir Hamza, Tunis, Tunisia

Introduction:
Cystic lymphangioma is a rare, benign neoplasm of lymphatic origin, usually presenting as a sporadic, solitary lesion. It typically occurs in the head and neck region but can occasionally develop intra-abdominally. When located in the abdomino-pelvic cavity, it may mimic other cystic masses and present diagnostic and therapeutic challenges. Laparoscopic surgery has become the gold standard for managing intra-abdominal cystic lesions, offering both precise exploration and safe, minimally invasive resection.

Case Presentation:
We report the case of a five-year-old girl who presented with paroxysmal abdominal pain, vomiting, and constipation. Physical examination was unremarkable. Abdominal ultrasound and CT scan revealed a large multilocular cystic mass measuring 125 × 35 × 71 mm, with polycyclic contours molding the intestinal loops, suggestive of a cystic lymphangioma. The patient underwent laparoscopy-assisted surgery, which allowed comprehensive exploration of the abdominal cavity. A multilocular, butterfly-shaped cystic mass extending over 15 cm of the ileum was identified. The mass was carefully externalized through the umbilical port, and an en-bloc resection with 2 cm safety margins was performed, followed by an end-to-end intestinal anastomosis.

Conclusion:
Abdomino-pelvic cystic lymphangioma in children is a rare condition requiring careful evaluation and complete surgical excision to prevent recurrence. Laparoscopy provides a minimally invasive approach with optimal visualization and safe resection. In this case, postoperative recovery was uneventful, and the patient remained asymptomatic with no recurrence after one year of follow-up.