Abdominal Cystic Lymphangiomas in Pediatrics: Surgical Approach and Outcomes

Abstract

ACL usually affect infants and young children and may present with spectrum of symptoms from an incidental finding to an acute life-threatening abdominal obstruction. Complete excision of the tumor is a safe and effective method in the management of ACL in pediatric population. Surgery is mandatory to avoid potential complications.

Japanese clinical practice guidelines for vascular anomalies 2017

“…<Review of observational studies (case series)> Seven papers 316,317,[320][321][322][323][324] among reviewed literature described asymptomatic LM. Fifteen cases reported in these papers were considered to have actually presented few symptom (including asymptomatic patients who were incidentally detected by imaging studies to have intra-abdominal masses at the sites as greater omentum, mesentery and retroperitoneum).…”

Identification of a Pediatric Intra-abdominal Cystic Lymphangioma Using Point-of-Care Ultrasonography

“…Intra-abdominal cystic lymphangiomas are a rare type of lymphangioma. 16 Drainage and sclerotherapy, the treatment methods used in our patient, have also been shown to be effective in childhood lymphangiomas. [12][13][14] Most patients present with abdominal pain; however, vague signs and symptoms such as vomiting, diarrhea, constipation, dysuria, anemia, abdominal distention, or ascites are also possible.…”

“…16 Drainage and sclerotherapy, the treatment methods used in our patient, have also been shown to be effective in childhood lymphangiomas. 12,13,16 Over time, follow-up sonography may show septal changes such as enlargement, multiplication, and thickening, whereas the cystic fluid may show increased echogenicity. It is considered by many to be the imaging study of choice for nontraumatic gastrointestinal emergencies, 9,18,19 and its liberal use in pediatric patients with vague or recurring pain is highly recommended.…”

“…It is considered by many to be the imaging study of choice for nontraumatic gastrointestinal emergencies, 9,18,19 and its liberal use in pediatric patients with vague or recurring pain is highly recommended. 15,16,[20][21][22] In a retrospective study by Méndez-Gallart et al, 16 10 of 10 patients were accurately diagnosed using ultrasound as a first-line radiologic study. 15,20 A cystic lymphangioma appears as a well-circumscribed, multilocular lesion with areas containing anechoic fluid or echogenic debris, separated by thin septa.…”

Abdominal Cystic Lymphangioma in Adults: Diagnostic Difficulties and Surgical Outcome

“…Most recurrences occur in patients with retroperitoneal cysts or those who had only a partial excision [22]. Location of the cyst does not influence the recurrence rate if it is resectable but surgery and hospital stay become more prolonged as in retroperitoneal and mesenteric root lymphangiomas [23]. The importance of surgical treatment of ACL is to avoid the potential cyst complications and reduce the incidence of recurrence, while, non-surgical treatments with bleomycin and steroids, or aspiration and injection of sclerosing agents as doxycycline has not been established to be superior to surgery, for the same reasons [19].…”