Mesenteric Lipoma in a Child: An Unusual Cause of Recurrent Abdominal Pain and Failure to Thrive

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  • Suganuma Rie
    Department of Surgery, Japan Community Health Care Organization Akita Hospital Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Morii Mayako
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Hebiguchi Taku
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Watanabe Ryo
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Azuma Saya
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Yamagata Kenki
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Hayashi Kaito
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Mizuno Masaru
    Department of Pediatric Surgery, Akita University Graduate School of Medicine
  • Ohtsuka Mihoko
    Department of Pediatrics, Japan Community Health Care Organization Akita Hospital
  • Yoshino Hiroaki
    Department of Pediatric Surgery, Akita University Graduate School of Medicine Department of Pediatric Surgery, Japanese Red Cross Akita Hospital

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Other Title
  • 繰り返す腹痛と発育不良を認めた小児腸間膜脂肪腫の1例
  • クリカエス フクツウ ト ハツイク フリョウ オ ミトメタ ショウニ チョウ カンマク シボウ シュ ノ 1レイ

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Description

<p>Mesenteric lipomas are relatively rare, benign tumors in children. We present a case of mesenteric lipoma in a child with symptoms of partial bowel obstruction, diagnosed preoperatively via abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). A 7-year-old boy with a history of recurrent abdominal pain and failure to thrive presented with symptoms of vomiting over the last four days. Physical examination revealed slight abdominal distention without a palpable mass. Plain abdominal radiography revealed small bowel loop distention, with a flat, dilated junction segment, indicating mechanical intestinal obstruction. Ultrasonography revealed a heterogenous echogenic mass lesion within the pelvic cavity. CT revealed a well-encapsulated nonenhancing mass with nodular organization and negative attenuation values. T1- and T2-weighted MRI sequences revealed that the mass showed hypersignal intensities and was mobile, which are indicative of mesenteric lipoma. Laparotomy revealed a smooth, round, soft, yellow mass measuring approximately 8.5×8.0×3.0 cm, arising from the mesentery, 80 cm proximal to the ileocecal valve. Resection of the affected segment of the ileum and end-to-end ileal anastomosis were performed. Histopathological analysis showed that the tumor was composed of mature adipocytes without atypia, confirming the diagnosis of mesenteric lipoma. The findings were negative for malignancy. No recurrence was observed during the two-year postoperative follow-up. The clinical presentation of the case was indicative of partial obstruction due to compression with spontaneous detorsion. Mesenteric lipoma should be considered a possible differential diagnosis in children with recurrent abdominal pain and failure to thrive.</p>

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