Laparoscopic treatment of a giant mesenteric cyst
Epublication WebSurg.com, Mar 2017;17(03). URL: http://websurg.com/doi/vd01en4909
Mesenteric cysts are very rare entities (annually worldwide estimated incidence of 1/140 000 inhabitants). They do not have pathognomonic features and require a differential diagnosis with lymphangiomas, sarcomas, adenocarcinomas, and intestinal duplications. They typically appear more in women (twice the incidence) and are mostly benign swellings (malignancy rate of about 3%). The gold standard treatment is laparoscopic surgical resection. The case is that of a 49-year-old female patient referred for an abdominal swelling in the periumbilical region, which was uncomfortable for the patient, namely in the contraction of the abdominals. She did not describe any changes in intestinal transit, anorexia, asthenia or associated weight loss. The imaging study by computer tomography documented a "cystic lesion of 13cm in the root of the mesentery in contact with great vessels and duodenum". The patient was resected laparoscopically in March 2016, discharged on the second postoperative day, without intercurrences. The video of the mesenteric cyst excision surgery demonstrates some of the risks of the laparoscopic approach of the mesentery and underlines the possibility of dissection of these cysts even when they are giant cysts and in close relation with vital structures such as the vena cava and the iliac arteries.