WOFAPS 2025 8th World Congress of Pediatric Surgery

Md Sharif Imam

Chattogram Maa-0-Shishu Hospital Medical College

Background:

Mesenteric cysts are intra-abdominal masses found in children, mainly caused by embryonic defects in the development of the lymphatic system. These cysts can occur anywhere along the mesentery of the gastrointestinal tract, from the duodenum to the rectum, and may even extend into the retroperitoneum.

Aim:

This study aims to evaluate the clinical findings, management strategies, and outcomes associated with mesenteric cysts at our institution.

Methods:

This study involved 27 pediatric patients who underwent surgery for mesenteric cysts at the Department of Pediatric Surgery of Chattogram Maa-O-Shishu Hospital Medical College between January 2019 and December 2024. We assessed clinical findings, radiological investigations, surgical procedures, histopathological evaluations, and follow-up data. All data were collected prospectively.

Results:

The median age at diagnosis was 5.25±1.5 years, with a male-to-female ratio of 0.68:1. The most common clinical manifestations were abdominal pain (70.3%), followed by a palpable abdominal mass (55.5%), and vomiting (25.9%). All patients underwent abdominal ultrasonography, which revealed a fluid-filled cystic mass in each case. An abdominal CT scan was performed on eleven patients (40.7%), confirming the cystic nature of the mass and providing details regarding its size, location, extent, and margins. The jejunal mesentery (55.5%) was the most common site of origin for mesenteric cysts, followed by the ileal mesentery (33.3%), and 11.2% originated from the sigmoid mesentery. The median size of the mesenteric cyst was 8.6 ± 4.4 cm, ranging from 4.5 cm to 22 cm. Complete and successful removal of the mesenteric cysts was achieved in all cases. Surgical management included enucleation (n =17), cyst excision combined with bowel resections and primary intestinal anastomosis (n =8), and laparoscopic resection of the cyst (n = 2). Post-operative complications included only wound site infections in three (11.1%) patients. Histologically, simple cyst was detected in 19 cases, and lymphangiomas in 8 cases. None of the patients experienced a recurrence of their condition.

Conclusions:

The most common presenting symptom of mesenteric cyst was abdominal pain. Jejunal mesentery was the commonest site. The relationships between the mesenteric cyst and adjacent organs largely influence the surgical approach.