Lymphangioma of the jejunum and mesentery presenting with acute abdomen in an adult

Abstract

We describe a patient, 54-year-old woman, with lymphangiomas of the jejunum and mesentery presenting as acute abdomen. She had sudden onset of severe abdominal pain with guarding and fever. Physical examination revealed an elastic hard mass, with marked tenderness in the right abdominal region. Ultrasonography and computed tomography revealed a heterogenous mass, 20 x 15 x 8cm in size, in the mesentery. An emergency operation was performed with the diagnosis of diffuse peritonitis due to an inflammatory tumor in the mesentery. At operation, the tumor was found in the mesentery, adhering to a 60-cm segment of the jejunum. Multiple small tumors were seen in the submucosal layer of jejunum. The tumor was excised with a 60cm length of the jejunum. Histologically, the tumors were diagnosed as cavernous lymphangiomas. Although lymphangioma in the abdomen is rare in adults, we should consider it as one of the causes of acute abdomen.

Cavernous mesenteric lymphangiomatosis mimicking metastasis in a patient with rectal cancer: A case report

“…Alternatively, cystic lymphangioma is composed of various-sized lymphatic spaces and has no connection with the adjacent normal lymphatics. However, as cystic lymphangiomas may have a cavernous area, clear differentiation between cystic and cavernous lymphangioma is not always possible [9,10] . Most intra-abdominal lymphangiomas are of cystic form and generally appear as a thin-walled, mutiseptated, cystic mass with or without intracystic debris.…”

“…The clinical symptoms of gastrointestinal and mesenteric lymphangiomas vary from being asymptomatic to acute abdominal symptoms such as obstruction or bleeding, according to the size and the localization of the tumor [10,12,13] . The treatment of choice is complete surgical resection.…”

Linfangioma mesentérico multiquístico como causa de vólvulo intestinal

“…En pacientes jóvenes su presentación habitual es en cabeza, cuello y axila, ocurriendo esporádicamente en órganos parenquimatosos tales como tejido óseo, hígado y bazo, muchas veces de forma difusa o multifocal (linfangiomatosis) 2 . Durante la adultez pueden presentarse como lesiones superficiales (linfangioma cutá-neo) o como linfangiomas intraabdominales, existiendo en este último caso una relación hombre: mujer de 3:2 3 .…”

“…El tipo de procedimiento varía según la localización de la lesión y el resultado cosmético esperado, en el caso de los linfangiomas de cabeza y cuello; y se guiará por la extensión de la lesión y compromiso de estructuras vecinas en el caso de los linfangiomas mesentéricos. La escisión completa del tumor es el tratamiento óptimo, aun incluyendo órganos adyacentes, ya que la resección incompleta puede llevar a la recurrencia de la lesión incluso varios años más tarde con un riesgo de recidiva de 10 a 15% [1][2][3][4][8][9][10][11][12] .…”

Giant Retroperitoneal Lymphangioma: a Rare Entity

“…These intraabdominal lymphangiomas are usually asymptomatic, or they can present rarely with complications like infection, bleeding, torsion, or hemorrhage [2]. Preoperative diagnosis is usually made on the basis of USG, CT, or MRI abdomen which shows characteristic features [1].…”