Duodenal duplication, intestinal malrotation and volvulus: An unusual cause of intestinal obstruction

Siviero, Ivonete; Forny, Danielle Nunes; Méio, Ivens Baker; Penna, Cláudia Renata Rezende; Ferrante, Saulo Marcos Rebello

doi:10.1016/j.epsc.2016.07.008

Cited by 1 publication

(2 citation statements)

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“…The most common differential diagnoses to consider in this case are enteric duplication cysts, mesenteric cysts, and broad ligament/ovarian cysts [12] . Enteric duplication cysts can be difficult to differentiate from mesenteric cysts pre-operatively, as both types of cysts can arise anywhere along the gastrointestinal tract from the duodenum to the rectum, and can have identical clinical features of abdominal mass and intestinal obstruction [12] . As such, a confirmatory diagnosis can only be made after exploration [7] .…”

Section: Discussionmentioning

confidence: 97%

“…The clinical manifestations of mesenteric cysts can range from asymptomatic intra-abdominal masses discovered incidentally, to acute abdomen secondary to intestinal obstruction (by extrinsic compression or volvulus) or from cyst rupture and hemorrhage. Our patient presented with midgut volvulus, which is most commonly a consequence of embryological intestinal malrotation, resulting from abnormal anatomical fixation of the bowel and mesentery within the abdomen [8] , [9] , [10] , [11] , [12] . This predisposes the small bowel to undergo volvulus along the axis of the superior mesenteric artery.…”

Section: Discussionmentioning

confidence: 99%

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Chylolymphatic mesenteric cyst with midgut volvulus in an adolescent: a peculiar presentation

Pai

Gudmundsdottir

Hull

et al. 2022

Radiology Case Reports

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Mesenteric cysts are rare intra-abdominal masses in the pediatric population, with the chylolymphatic variant comprising only 7.3% of all abdominal cysts. These cysts can have a varied clinical presentation, ranging from asymptomatic cystic masses to intestinal obstruction. We report a 16-year-old female, who presented with acute abdominal pain and vomiting, and was diagnosed with an intra-abdominal cystic mass with midgut volvulus accompanied by the classical “whirlpool sign” on imaging. She underwent laparoscopic abdominal exploration, which revealed a large chylolymphatic mesenteric cyst associated with feeder lymph vessels. This cyst had resulted in volvulus of the small bowel. The bowel was detorsed and found to be viable, and the cyst was removed en bloc after suction evacuation with ligation of the lymphatic feeder vessels. Midgut volvulus in the pediatric population is usually secondary to malrotation, but in this case the patient's small intestine was not found to be malrotated, and hence we present this case and urge physicians to consider a diagnosis of midgut volvulus even in the absence of malrotation in a child with a cystic abdominal mass presenting as intestinal obstruction.

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Section: Discussionmentioning

confidence: 97%