Multiannual abdominal pain complicated by obstruction of the gastrointestinal tract in the course of cystic form of mesenteric lymhangioma of the small intestine

Abstract

Lymphangiomas constitute a group of very rare diseases and occur with a frequency of 1/250,000 to 1/20,000 of hospitalizations. Even though they are benign lesions, their complications may turn into a life-threatening condition. They usually occur in children (90%), they are either congenital or they appear before the child's second birthday. Occassionally they are found in adults. Lymphangiomas are usually localized around neck, but also near armpits and in the groin area. Less than 1% of lymphagiomas are detected in the retroperitoneal space and intestinal mesentery. Vascular lesions derived from lymphatic vessels can be divided into ordinary ones, usually known as capillary, cavernous, and cystic. The cystic tumor (lymphangioma mesenteri) is the least common. It occurs mostly in the retroperitoneal space, mesentery of the colon, or extremely rarely in the mesentery of the small intestine. Preoperative diagnosis is difficult due to non-specific clinical symptoms and noncharacteristic image in the diagnostic tests. Lymphangioma complications, such as intestinal obstruction or perforation, and persistent pain, are the cause of exploratory laparotomy. Final diagnosis requires microscopic examination of material collected during an operation. This article presented the case of a 40-year-old female, operated due to the obstruction of the gastrointestinal tract, in whose case the lymphangioma was recognised in postoperative histopathological examination of the tumor from the jejunal mesentery. Since patients with these tumors have good chances of complete recovery -if there are no serious complications -it appears that the optimal therapeutic procedure should be early surgery, which reduces the possibility of complications.

Emergency presentation of cystic lymphangioma of the colon: A case report and literature review

“…The clinical symptoms of a mesenteric lymphangioma are non-specific and include abdominal pain, vomiting and constipation. Lower GI bleeding, obstruction, intussusception and protein-losing enteropathy are rare complications [7] , [8] , [9] , [10] , [11] , [12] . The cardinal sign of our case was anemia, which may be due to the serosanguinous cystic contents of lymphangiomatosis from the internal bleeding that in our case led to an impairment of the haemodinamic status.…”

Unusual location and complication of a cystic lymphangioma: A case report

“…Lymphangiomas are usually incidentally found by explorations done for other purposes.In some cases, the patients present with nonspecific symptoms and elective surgery is usually performed. However, complicated cystic lymphangiomas are not much described in literature and consist in lower gastrointestinal bleeding, obstruction, intussusception and protein-losing enteropathy [ [7] , [8] , [9] , [10] , [11] , [12] ] [ [7] , [8] , [9] , [10] , [11] , [12] ] [ [7] , [8] , [9] , [10] , [11] , [12] ]. Therefore, it is uncommon for cystic lymphangiomas to cause severe, life-threatening abdominal symptoms in adults.What makes our case report unusual is that the chief symptom was a severe abdominal pain with signs of peritoneal irritation due to infected cystic lymphangioma.…”