Intraabdominal Cystic Lymphangiomas in Children: A Single Center Experience

Abstract

Congenital intraabdominal cystic lymphangiomas (ICLs) are rare disorders. Only a minority of cases present with acute illness, the majority of patients show unspecific abdominal symptoms, and due to the slow progression of ICL the diagnosis is usually made with delay. We report our single center experience concerning ICL covering a 3-year period from 2009 to 2011. During this time three patients with a mean age of 2.8 years were first seen because of unspecific abdominal symptoms, and were identified to have an ICL, originating from the ligamentum gastrocolicum (diameter 17 cm), gastrolienale (diameter 20 cm) and omentum majus (diameter 7 cm). The following report should emphasize the diagnostic difficulty associated with ICL presenting three patients in excellent condition, showing normal laboratory data despite a considerable persistent intraabdominal fluid accumulation. The persistence of “ascites” in parallel with the follow-up sonographies demonstrating cystic masses and internal septations led to the differential diagnosis of an ICL. To us, it seems to be important to bear in mind ICL as a relevant differential diagnosis in children with unspecific abdominal pain or non-specific ascites. This is to point out that especially the existence of septated intraabdominal fluid and cystic structures are strong signs leading to the diagnosis of an ICL. Due to this, the general use of ultrasonography (US) in children with unspecific abdominal symptoms should be recommended. Int J Clin Pediatr. 2014;3(3):89-93 doi: http://dx.doi.org/10.14740/ijcp163w