RARE CASE OF INFECTED MESENTERIC CYST WITH POST OPERATIVE DUODENAL FISTULA- A CASE REPORT

Abstract

Mesenteric Cysts are rare intra-abdominal tumors occurring in the mesentery of intestine, may contain chyle or serous uid, and have variable presentations[1]. One such case was managed at our institution. A 70-year-old male patient presented with history of mass per abdomen associated with pain for 10 days. On clinical examination palpable mass of size approximately 10*10cm in the epigastric, umbilical region, along with an incisional hernia at the same site. CECT abdomen revealed a collection of size 13*12*7cm in mesentery extending from epigastric to umbilical region, with a midline defect in the rectus of size 10*7cm. Emergency exploratory laparotomy was performed and cyst identied, oozing of pus was noted. Marsupialization of cyst cavity was done. Postoperatively, bilious output noted through the RFD. Oral contrast CT revealed contrast leak from D3 of duodenum, with stulous communication into the cyst. Under uoroscopic guidance, NJ tube was passed beyond the site of stulous communication. Subsequent drop in RFD output was observed. Patient was followed up for 6 months, subsequent course was uneventful.