Bronchogenic cyst of the ileal mesentery: a case report and a review of literature

Adolfo Petrina,Stefano Trastulli,Piero Covarelli,Emilio Eugeni,Carlo Boselli,Luigi Finocchi,Marco Badolato,Roberto Cirocchi,Giuseppe Noya

doi:10.1186/1752-1947-4-313

Abstract

IntroductionBronchogenic cyst is a rare clinical entity that occurs due to abnormal development of the foregut; the majority of bronchogenic cysts have been described in the mediastinum and they are rarely found in an extrathoracic location.Case presentationWe describe the case of an intra-abdominal bronchogenic cyst of the mesentery, incidentally discovered during an emergency laparotomy for a perforated gastric ulcer in a 33-year-old Caucasian man.ConclusionsBronchogenic cyst should be considered in the differential diagnosis of subdiaphragmatic masses, even in an intraperitoneal location.

Highlights

Bronchogenic cyst is a rare clinical entity that occurs due to abnormal development of the foregut; the majority of bronchogenic cysts have been described in the mediastinum and they are rarely found in an extrathoracic location
The laryngotracheal groove appears at the end of the third week of gestation in the embryonic foregut [1]; the dorsal portion of the foregut elongates to form the esophagus, and the ventral portion differentiates into the respiratory tract, with ciliated epithelium lining both the fetal esophagus and trachea [1,2,3]
Bronchogenic cysts form from accessory ventral buds arising from the foregut distal to the future lung at about the fifth week of intra-uterine life; the majority of bronchogenic cysts have been described in the mediastinum (90%, most commonly in the posterior aspect of the superior mediastinum [4,5,6,7,8]) and they are rarely found in an extrathoracic location; a small number of them have been reported in abdominal location, with prevalence in the retroperitoneal space [9,10,11,12]

Summary

Introduction

The laryngotracheal groove appears at the end of the third week of gestation in the embryonic foregut [1]; the dorsal portion of the foregut elongates to form the esophagus, and the ventral portion differentiates into the respiratory tract, with ciliated epithelium lining both the fetal esophagus and trachea [1,2,3]. We report a bronchogenic cyst incidentally discovered as a small intra-peritoneal mass in our patient, who was admitted to our surgical unit for acute abdominal pain due to gastric ulcer perforation. Case report Our patient, a 33-year-old Caucasian man, was referred to our institution for acute abdominal pain; the symptoms had begun two days earlier as a mild epigastric pain that localized the following day in the right iliac fossa. He had no instances of nausea or vomiting at admission, a body temperature of 37.2°C, a white blood cell count of 20.30 cells/mm (polymorphonuclear leukocytes 84.6%) and sluggish peristalsis. Our patient was discharged on the twelfth post-operative day

Discussion

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Conclusion