Large Abdominal Cyst Research Articles

Mesenteric cyst in a newborn. A case report

We present a case report of a 1.5-month-old infant admitted to the Department of Paediatric Surgery on an elective basis in order to diagnose and treat an abdominal lesion identified in ultrasound examination during the prenatal period. Computed tomography with contrast of the abdominal cavity and pelvis showed a large abdominal cyst measuring 11 × 8 × 7 cm. Consequently, the child was referred for surgery. During the procedure, the cyst was completely dissected. Outside the abdominal cavity, it was decompressed from the blood-serous fluid. Intraoperatively, intestinal malrotation and right ovarian agenesis were additionally diagnosed. The material for histopathological examination was handed over in full. Microscopically, mesenteric lymphangioma was diagnosed.

A large abdominal cyst in a neonate

Gastrointestinal (enteric) duplication consists of a tubular or cystic structure that develops along the intestinal tube, with an estimated incidence of 1/10,000 in live births and 1/4500 in necropsies of neonates and fetuses. This congenital anomaly can appear in any portion of the intestinal tract; from the mouth to the rectum, with the ileum being the most common location. We herein report the case of a 5-day-old patient with a prenatal diagnosis of megacolon or mesenteric cyst. At laparotomy, a cystic mass attached to the terminal ileum was noted approximately 5 cm from the ileo-caecal valve. This mass was entirely resected and pathology studies classified the specimen as Type 1B intestinal duplication according to the Long classification. Intestinal duplications are rare abnormalities of the embryological development of the gastrointestinal tract and usually present in childhood. The diagnosis can be made during antenatal follow-up. They can be asymptomatic or present with a variety of symptoms in relation to the location, the age of the patient or complications of the duplication. The diagnosis is suggested by abdominal X-rays and ultrasonography, and computerized axial tomography scan with contrast studies, but the definitive diagnosis is made by histopathological examination of the surgical specimen.

Large abdominal cyst of the fetus: A rare diagnosis of neonatal megaduodenum

We present a rare case of neonatal duodenal malformation. Herein, we provide a differential diagnosis for a large abdominal cyst in a prenatal fetus and explore the possible causes and treatment of neonatal megaduodenum. We retrospectively analyzed one case of megaduodenum from fetal examination to neonatal diagnosis and treatment. Ultrasonography of the fetus at 12 weeks' gestation revealed a cystic mass in the abdominal cavity, measuring about 0.7 cm × 0.5 cm × 0.4 cm. The cystic mass grew in equal proportion to the fetus. At 32 weeks’ gestation, the peritoneal cystic mass was enlarged to 9.0 cm × 7.9 cm × 5.8 cm, and the mass was found to be communicating with the stomach. Intraoperatively, the mass was about 10-cm long and 6 cm in diameter. The duodenal papilla was located about 1.5 cm above the proximal junction. The megaduodenum was removed, and the distal and proximal intestines were anastomosed end-to-end. The patient recovered smoothly postoperatively and gained 550 g 1 month after discharge. The results of amniotic fluid high-throughput sequencing identified Seq [Grch37] del (16) (p12.2) Chr16: g.22000000_22440000del. There was a copy number deletion of about 0.44 Mb on the short arm of chromosome 16, which was suspected to be pathogenic and involved seven protein-coding genes. Histopathologically, in the same paraffin specimen, there was a mixture of stunted ganglion cells, ganglion dysplasia, and well-developed ganglion cells. Neonatal megaduodenum was considered as a differential diagnosis of the large cystic mass in the fetal abdomen. Further additional evidence was needed to prove whether the mutation was pathogenic, which also suggested that the etiology is related to genetic variation. The nerve plexus and ganglion cells were poorly developed, which further supported that the intestinal nerve abnormality was the etiology. Excision was safe and effective for treating megaduodenum.

Torsion of proximal pouch in ileal atresia presenting as a large abdominal cyst

Torsion of proximal pouch in ileal atresia presenting as a large abdominal cyst

Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report

BackgroundEndometriosis is an estrogen-dependent disease defined by the presence of endometrial glands and stroma out of the uterine cavity. Its prevalence is estimated to be 2–10% in reproductive aged women. Endometriosis occurrence is estimated to be 2.55% in postmenopausal patients due to the decreased levels of estrogen. Endometriosis can present in three different forms: superficial peritoneal implants, ovarian endometriomas, and deep infiltrating endometriosis. Ovarian endometriomas are the most common form of endometriosis. Even though endometriomas have been encountered in various localizations, a free abdominal endometrioma was only reported once in a premenopausal patient. Here, we are reporting the first case of a free large endometrioma in a postmenopausal patient.Case presentationA 67-year-old woman presented to the emergency department at our university hospital complaining of constipation and right flank pain. She suffered from uncontrolled primary hypertension and type 2 diabetes mellitus. On presentation, she was afebrile, hypertensive, and tachycardic. An abdominal CT scan revealed a large cystic mass measuring 17 × 26 cm in the anterior-posterior and transverse diameters respectively. The cyst caused bowel obstruction and right sided hydronephrosis. The patient underwent laparotomy and during the surgical exploration a large abdominal cyst adhered to the greater omentum was found. The cyst received plenteous blood supply from the greater omentum. The uterus and both ovaries were completely normal and didn’t have any connection to the cyst. An en-bloc cystectomy was performed successfully. The final histopathology report confirmed an abdominal endometrioma. The patient had an uneventful postoperative recovery.ConclusionsEndometriomas might reach large sizes regardless of their location or the patient’s age. The close relation of free abdominal endometriomas with the greater omentum suggests that these were developed from endometriotic omental implants. Endometrioma is rare in postmenopausal women. However, it should be considered as a possible differential diagnosis at any age.

Prenatal diagnosis of a large abdominal cyst – Recommendations and management

Abstract This case report describes a twin fetus diagnosed in the third trimester with an enlarging abdominal mass that was confirmed on fetal magnetic resonance imaging (MRI) to be a hepatic mesenchymal hamartoma (HMH) without involvement of the placenta. Serial ultrasonography demonstrated progressive enlargement of the mass and infant was delivered at 33 + 6 weeks gestational age following maternal complications. On the fifth day, at laparotomy, a huge mass connected to the lower portion of the liver was completely resected. Microscopic evaluation confirmed a hepatic mesenchymal hamartoma. Postoperative recovery was uneventful and the infant was discharged at 4 weeks. The antenatal diagnosis of the hepatic mesenchymal hamartoma by fetal MRI and subsequent follow-up by serial ultrasonography emphasizes the importance of combining these 2 modalities for optimal management of the pregnancy to allow a favorable outcome.

Large Abdominal Cyst That was Identificated During Neonatal Period

Large Abdominal Cyst That was Identificated During Neonatal Period

Laparoscopic Excision of a Gastric Lymphatic Malformation

Abstract Lymphatic malformations occurring within the abdominal cavity are rare benign lesions predominantly affecting the pediatric population. We report an acute presentation of an unusual and extensive lymphatic malformation, arising in the lesser sac, in a 15-year-old girl. After imaging, the cystic mass was thought to be of adnexal origin. A laparoscopic resection of this presumed adnexal mass was planned. A supra-umbilical, 12-mm trocar was placed by Hasson technique. A 5-mm, 30-degree scope was used to examine the abdominal cavity, revealing a large abdominal cyst that was mobile. Two more 5-mm trocars were then placed in the left lower and right lower quadrant regions. Manipulation of the mass demonstrated a nonpelvic origin and normal adnexae. The mass was connected by a twisted pedicle traveling over the transverse colon through the greater omentum. An omental origin was suspected at this point, but the superior border of the mass could not be delineated. Another 5-mm trocar was placed in the le...

Laparoscopic Excision of an Omental Leiomyoma with a Giant Cystic Component

Primary tumors of the omentum are uncommon, and leiomyomas arising in the omentum are exceedingly rare. We report on a patient who presented with a large abdominal cyst presumed to be an omental cyst. At laparoscopy, after aspiration, the cyst was found to be attached to a solid mass arising from the greater omentum. The entire tumor was successfully excised laparoscopically. Histopathology and immunohistochemistry revealed it to be an omental leiomyoma with a large degenerative cystic component. Treatment by a minimal access approach allowed the patient to recover rapidly with a short convalescence. Our case confirms the feasibility and safety of a minimal access surgical approach to a rare pathological entity.

1269: Percutaneous US-guided Aspiration of Asymptomatic Neonatal Ovarian Cyst Torsion: A Case Report and Literature Review

Ovarian cysts are common incidental findings in term infants and, when unusually large, may result in torsion, rupture, or intestinal obstruction. Treatment options include conservative management, antenatal or neonatal cyst aspiration and laparoscopic surgery. We report a case of US-guided aspiration for the treatment of neonatal ovarian cyst with an intra-uterine torsion. A female infant was vaginally delivered at 41 weeks of gestation and a large abdominal cyst (approximately 4.4 cm in diameter) with a fluid-debris level was detected on the antenatal and neonatal sonographies. She was healthy with no sign of acute abdomen. Percutaneous US-guided fine needle aspiration was performed for the cyst on the 3rd day after birth and approximately 10 ml of dark red colored fluid was aspirated. The cyst was significantly decompressed, and the diameter was decreased by half. Gradual increase of the cyst size up to 3.2 cm in diameter was detected on the successive follow-up ultrasonograms until the baby was 2 months old, and thereafter, gradual decrease until 1yr old. On the last ultrasonographic examination, the cystic component disappeared completely and an approximately 1.5 cm sized ovoid nodule like structure with peripheral tiny anechoic dots seemed like a normal ovary was demonstrated. US-guided aspiration could be a treatment of choice for a large asymptomatic neonatal ovarian cyst torsion and expect a good result even though the cyst shows transient growth by fluid refilling.

Successful Excision Of An Enormous Mesenteric Lymphangioma In An Adult: Report Of A Case

We herein describe a case of a 20-year-old male, who presented with a large abdominal cyst. Repeated therapeutic aspiration of the cyst was followed by rapid recurrence. Preoperative imaging studies demonstrated a massive cyst occupying most of the abdomen. At laparotomy, a giant cyst (39 x 29 x 15cm) of the mesentery was found. It was attached to the anterior and posterior abdominal walls and extended from the undersurface of the liver to the urinary bladder. Histopathologic examination diagnosed the cyst as a cystic lymphangioma. Although mesenteric lymphangiomas are rare, especially in adults, they may sometimes present as painless increase of the abdominal girth and grow to an enormous size. Complete surgical removal is considered to be the procedure of choice.

Successful Excision Of An Enormous Mesenteric Lymphangioma In An Adult: Report Of A Case

We herein describe a case of a 20-year-old male, who presented with a large abdominal cyst. Repeated therapeutic aspiration of the cyst was followed by rapid recurrence. Preoperative imaging studies demonstrated a massive cyst occupying most of the abdomen. At laparotomy, a giant cyst (39 x 29 x 15cm) of the mesentery was found. It was attached to the anterior and posterior abdominal walls and extended from the undersurface of the liver to the urinary bladder. Histopathologic examination diagnosed the cyst as a cystic lymphangioma. Although mesenteric lymphangiomas are rare, especially in adults, they may sometimes present as painless increase of the abdominal girth and grow to an enormous size. Complete surgical removal is considered to be the procedure of choice.

Transient kyphotic deformity of the thoracolumbar junction resulting from a large abdominal cyst: a case report

Background context Pronounced kyphosis of the thoracolumbar junction is a common orthopedic problem in adolescents and may require prolonged bracing therapy or correction spondylodesis. Purpose To describe a case where a kyphotic deformity was related to gynecological instead of spine pathology. Study design Case report. Methods A 17-year-old girl presented with a structural hyperkyphosis of the thoracolumbar spine and radiographic changes of the involved vertebral end plates. Results The thoracolumbar hyperkyphosis appeared to have evolved from a massive intra-abdominal ovarian cyst. Endoscopic paracentesis of the cyst resulted in a complete regression of the hyperkyphosis. Conclusions A hyperkyphosis is not always related to spine pathology, and other potential causes must be excluded before bracing therapy is initiated.

Abdominal compartment syndrome due to a large abdominal cyst

Abdominal compartment syndrome due to a large abdominal cyst

Abdominal cyst formation following ventriculoperitoneal shunt in a case of hydrocephalus due to cryptococcal meningitis: Case report: Completely cured by surgical removal of the cyst and treatment with a newly developed anti-fungal drug (Difulcan)

A 54-year-old woman was admitted to the hospital for evaluation of meningitis. Tuberculous meningitis was suspected initially because of general findings and a high adenosine deaminase activity (ADA) value in the cerebrospinal fluid. Administration of antituberculous drugs was not effective. Computed tomography scanning revealed progression of ventricular enlargement. A ventriculo-peritoneal shunt was placed upon diagnosis of hydrocephalus due to meningitis. The presence of a large abdominal cyst formation was demonstrated. Cryptococcus was detected in the cyst fluid, leading to a diagnosis of cryptococcal meningitis. Intravenous administration of fluconazole (400 mg/day) was begun. Excision of the cyst was performed when Cryptococcus was no longer detected in the cyst fluid. The patient recovered uneventfully.

腹腔内巨大嚢胞を形成したひ膿ようの１例

腹腔内巨大嚢胞を形成したひ膿ようの１例