A Case of Small Bowel Mesenteric Lymphangioma with Acute Abdomen Treated by Laparoscopic Surgery

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  • 腹腔鏡下に治療した急性腹症を呈する小腸間膜リンパ管腫の1例
  • フククウキョウ カ ニ チリョウ シタ キュウセイ フクショウ オ テイスル ショウチョウ カンマク リンパカン シュ ノ 1レイ

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Abstract

<p>Small bowel mesenteric lymphangioma is a relatively rare disease, and preoperative diagnosis is often difficult. A 10-year-old child was brought to our hospital with progressively worsening right lower abdominal pain. Physical examination revealed tenderness and rebound tenderness in the right lower abdomen. Laboratory examination showed an elevated inflammatory responses（WBC count 12,000/μL and serum CRP 0.04mg/dL）. Contrast-enhanced abdominal CT revealed a mildly enlarged appendix, a positive whirl sign at the end of the superior mesenteric artery, and a mass in the pelvis showing poor contrast enhancement. An emergency operation was performed for acute abdomen on the same day. Laparoscopic examination revealed a multifocal cystic lesion bordering the small intestine, about 70 cm from the ligament of Treitz, with minimal inflammation of the appendix. We performed laparoscopic resection of the appendix and partial resection of the ileum. Histopathological examination revealed minimal inflammation of the appendix, and the cystic lesion was diagnosed as a mesenteric lymphangioma. The patient was discharged from the hospital without any complications on the 6th postoperative day, and no recurrence has been observed since. Preoperative diagnosis of small bowel mesenteric lymphangioma is sometimes difficult, and laparoscopic surgery may be useful, including for diagnostic purposes, in cases of small bowel mesenteric lymphangioma presenting with an acute abdomen.</p>

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