Assuntos

RESUMO

BACKGROUND: Mesenteric cysts are very rare abdominal growths, generally asymptomatic, and which are usually detected incidentally while performing a physical examination or an imaging test. Complications such as infections, haemorrhage, torsion, rupture, or bowel obstruction, are seldom found in this pathology, but they can be a cause of acute abdomen. The purpose of this report is to describe the characteristics and the clinical outcome of a male patient with an infected mesenteric pseudocyst of the jejunum. CLINICAL CASE: A 49 year-old male was admitted to the emergency department with 6-day onset of abdominal pain, bowel obstruction signs, palpable tumour located in the upper hemi-abdomen, systemic inflammatory response syndrome, 36,100/mm(3) white cells, 4.21 ng/ml procalcitonin, abdominal computed tomography scan with evidence of a mesenteric cystic tumour. An exploratory laparotomy was performed, finding the presence of a mesenteric pseudocyst of the jejunum with infection signs, extirpated and sent for histopathological examination. The clinical progress of the patient was satisfactory with the discharge of the patient 7 days after the surgical intervention. CONCLUSION: These cysts can debut as an acute abdomen due to haemorrhage, infection, obstruction and/or bowel perforation, complications can be life threatening if not detected and surgically treated at an early stage by performing a resection of the pseudocysts, with or without bowel resection, depending on the location and the size of the cyst.

Assuntos

Assuntos

Assuntos

RESUMO

Se revisan los casos de niños operados con diagnóstico de quiste de epiplón (QE) y mesenterio (QM) en el período de Agosto 2003 a Agosto 2013, en el Hospital Dr. Gustavo Fricke de Viña del Mar. Estos son quistes intraabdominales de escasa frecuencia, que evolucionan como tumoración asintomática, pudiendo presentar diversas manifestaciones clínicas desde constipación, vómitos y dolor hasta ser causa de abdomen agudo en el niño. La radiografía de abdomen simple y el ultrasonido pueden ser de utilidad para plantear la sospecha diagnostica, siendo la tomografía computada el estudio de excelencia en estos casos. Se encontró tres pacientes, dos QE y un QM. Los motivos de consulta fueron: masas abdominal (QE), dolor abdominal recurrente (QM) y abdomen agudo (QM). El diagnóstico se confirmó con TAC y se realizo exéresis total de la lesión en todos los casos. En un paciente fue necesaria la resección intestinal complementaria (QM). No hubo complicaciones en nuestros casos.

This is a case review of operated children with diagnosis of omentum cysts (OC) or mesentery cysts (MC), since August 2003 to August 2013 at Dr. Gustavo Fricke Hospital, Viña del Mar, Chile. These are rare intraabdominal lesions that frequently evolve as an asymptomatic tumor; clinical manifestations are constipation, vomits, abdominal pain and occasionally may be cause of acute abdomen in the child. The abdominal radiography and ultrasound may be useful, but the abdominal pelvic CT scan is the gold standard in these affections. Three cases were found, two OC and one MC. Symptoms were: abdominal tumor (OC), recurrent abdominal pain (OC) and acute abdomen (MC). Diagnosis confirmation was made with TC scan in all cases. Total exeresis of the benign tumor lesion was performed in all cases. In one patient it was necessary to perform intestinal resection for the tumor exeresis (MC). There were no complications.

Assuntos

RESUMO

Los quistes mesentéricos son tumoraciones abdominales raras. Cerca de 60% de estos quistes ocurren antes de los 5 años de edad y pueden localizarse en cualquier punto del tracto gastrointestinal, aunque son mas frecuentemente encontrados en el mesenterio del intestino delgado. La presentación clínica depende de la localización y tamaño del quiste y muchos de los casos son asintomáticos y son diagnosticados incidentalmente. Los síntomas más frecuentes son dolor abdominal, distensión abdominal, masa abdominal, náuseas, vómitos, constipación, diarrea, pérdida de peso, fiebre y peritonitis. Las complicaciones incluyen torsión, infarto, formación de vólvulos, perforación, infección, anemia por hemorragia intraquística, obstrucción intestinal y uropatía obstructiva. Son típicamente tratados por escisión simple, marsupialización o resección intestinal segmentaria y tienen un excelente pronóstico a largo plazo...

Mesenteric cysts are rare abdominal tumors. About 60% of these cysts occurs before 5 years of age and can be located anywhere in the gastrointestinal tract, but are most often found in the small bowel mesentery. The clinical presentation depends on the location and size of the cyst and many cases are asymptomatic and are diagnosed incidentally. The most common symptoms are abdominal pain, bloating, abdominal mass, nausea, vomiting, constipation, diarrhea, weight loss, fever and peritonitis. Complications include torsion, infarction, volvulus formation, perforation, infection, anemia, intracystic hemorrhage, intestinal obstruction and obstructive uropathy. They are typically treated by simple excision, marsupialization or segmental bowel resection and have excellent long-term prognosis...

Assuntos

RESUMO

Mesenteric cysts are rare abdominal tumors. About 60% of these cysts occurs before 5 years of age and can be located anywhere in the gastrointestinal tract, but are most often found in the small bowel mesentery. The clinical presentation depends on the location and size of the cyst and many cases are asymptomatic and are diagnosed incidentally. The most common symptoms are abdominal pain, bloating, abdominal mass, nausea, vomiting, constipation, diarrhea, weight loss, fever and peritonitis. Complications include torsion, infarction, volvulus formation, perforation, infection, anemia, intracystic hemorrhage, intestinal obstruction and obstructive uropathy. They are typically treated by simple excision, marsupialization or segmental bowel resection and have excellent long-term prognosis.

Assuntos

RESUMO

Se presenta el caso de una mujer de 23 años de edad, sin síntomas específicos ni antecedentes patológicos importantes, con un diagnóstico por imágenes de dos quistes ováricos. Durante la laparotomía se encontró que un supuesto quiste de ovario resultó ser un quiste del mesenterio. Ambos quistes fueron extirpados.

This is a case of a 23 year-old female patient, with no specific symptoms and without a relevant pathological record, with a CT scan diagnosis of two ovarian cysts. Under laparotomy, it was found a mesenteric cyst misdiagnosed as an ovarian cyst. Both cysts were excised.

Assuntos

Assuntos

Assuntos

RESUMO

OBJECTIVE: To evaluate epidemiologic, clinical, pathologic and therapeutic characteristics of the mesenteric cysts in hospitals of Sergipe, Brazil. METHODS: Mesenteric cysts were assessed by a non-interventional cross-sectional study from the archives of the Pathology Laboratory of Federal University of Sergipe between 1995 and 2007. The charts of the patients were reviewed in order to find out: gender, age, clinical findings, complementary exams and therapeutic approach. RESULTS: Eighteen cases of mesenteric cysts were found. Females were more affected (72.2%). Mean of age of the patients was 30.46. More frequent symptoms were pain and abdominal mass. Ultrasonography of abdomen, performed in all patients, was not conclusive in half of the cases. CTscan of abdomen with contrast was performed in six cases, being cystic tumor well identified in all of them. Regarding histopathology, 6 lymphangiomas, 8 mesotheliomas, 1 hemorrhagic cyst in organization and 1 mucinous cyst were found. Surgical treatment was performed in all cases. Intracystic bleeding was the main complication in 3 cases. CONCLUSION: The mesenteric cysts presented clinically with unspecific symptoms. CTscan was more effective than ultrasonography for the diagnosis. Lymphangiomas and mesothelioma had been found in equal ratios. The complete resection of the cyst was the treatment of election. There were no deaths in postoperative period.

Assuntos

RESUMO

OBJETIVO: Discutir aspectos epidemiológicos, clínicos, anátomo-patológicos e terapêuticos de cistos mesentéricos atendidos em hospitais do Estado de Sergipe. MÉTODOS: Estudo observacional, descritivo e transversal, consistindo de um levantamento de uma série de casos de cistos mesentéricos, nos arquivos do Laboratório de Patologia da Universidade Federal de Sergipe no período de 1995 a 2007. Revisaram-se os prontuários dos pacientes para coleta de dados: gênero, idade, quadro clínico, exames complementares e abordagem terapêutica. RESULTADOS: Foram encontrados 18 casos de cistos mesentéricos. O gênero predominante foi o feminino (72,2 por cento). A média de idade dos pacientes ao diagnóstico foi de 30,48 anos. Os sintomas mais freqüentes foram dor e massa abdominal. A ultra-sonografia de abdome, realizada em todos os pacientes, não foi conclusiva em metade dos casos. Tomografia computadorizada de abdome com contraste foi realizada em seis casos, sendo a tumoração cística bem evidenciada em todos estes. Quanto ao tipo histopatológico foram encontrados oito linfangiomas, oito cistos mesoteliais, um cisto hemorrágico em organização e um cisto mucinoso. O tratamento cirúrgico foi empregado em todos os casos. Hemorragia intracística foi a principal complicação apresentada, ocorrendo em três casos. CONCLUSÃO: Os cistos mesentéricos apresentaram-se clinicamente com sintomas inespecíficos e pouco sintomáticos. Quanto ao diagnóstico, a tomografia computadorizada mostrou ser mais efetiva que a ultrassonografia. Linfangiomas e mesoteliomas foram encontrados em proporções iguais. A ressecção completa do cisto foi o tratamento de eleição e não houve óbitos no pós-operatório.

OBJECTIVE: To evaluate epidemiologic, clinical, pathologic and therapeutic characteristics of the mesenteric cysts in hospitals of Sergipe, Brazil. METHODS: Mesenteric cysts were assessed by a non-interventional cross-sectional study from the archives of the Pathology Laboratory of Federal University of Sergipe between 1995 and 2007. The charts of the patients were reviewed in order to find out: gender, age, clinical findings, complementary exams and therapeutic approach. RESULTS: Eighteen cases of mesenteric cysts were found. Females were more affected (72.2 percent). Mean of age of the patients was 30.46. More frequent symptoms were pain and abdominal mass. Ultrasonography of abdomen, performed in all patients, was not conclusive in half of the cases. CTscan of abdomen with contrast was performed in six cases, being cystic tumor well identified in all of them. Regarding histopathology, 6 lymphangiomas, 8 mesotheliomas, 1 hemorrhagic cyst in organization and 1 mucinous cyst were found. Surgical treatment was performed in all cases. Intracystic bleeding was the main complication in 3 cases. CONCLUSION: The mesenteric cysts presented clinically with unspecific symptoms. CTscan was more effective than ultrasonography for the diagnosis. Lymphangiomas and mesothelioma had been found in equal ratios. The complete ressection of the cyst was the treatment of election. There were no deaths in postoperative period.

Assuntos

RESUMO

Mesenteric cysts are rare, it had been reported a frequency of 1 in 250,000 hospital admissions. We present a case of a 17-year-old female, attended at gynecology service with 8 weeks amenorrhea and diffuse pain in all abdominal regions. Without preceding pathological history of importance, menarche at 14 year, menstrual cycles of 30-45 x 5, nuligesta. She had negative immunology pregnancy tests, and sonography showed left ovary with anecoique ovoid area of approximately 15 x 8.8 x 7 cm. Physical examination showed a soft abdomen, depressible, with pain on the left side, where presence of a tumor of approximately 8 cm was perceived. Vaginal examination showed cervix of 3 x 2 cm, not painful to mobilization, uterus in a head position of 6 x 5 x 4 cm, a tumor of 18 x 10 cm was delimited in left salpinge, not painful to the compressedness. It was carried out a laparotomy with diagnostic of cyst in left ovary, but it was a tumor of 18 x 14 x 10 cm of cyst aspect that was dependented of mesenterious at sigmoid colon level, which could be eradicated without difficulty. Mesenteric tumors are difficult for diagnosis, and can be asymptomatic or to be suspect as cause of recurrent abdominal pain, abdominal tumor or acute abdomen. Unfortunately, it is difficult to establish the diagnosis with precision before surgery, still employing diagnostic resources of high technology, as sonography and tomography.

Assuntos

RESUMO

Mesenteric cysts are lesions that appear very rare. Its incidence ranges from 1:20,000 in children and 1:100,000 in adults. Their clinical manifestations are atypical and they include abdominal pain, vomit, tumor and complications from hemorrhage, peritonitis when there is a rupture of infected cyst, intestinal occlusion, renal failure, volvulus and malignant transformation. We present a case of mesenteric cyst, located in the mesoappendix with slight vascular compromise and chronic symptoms, its treatment and evolution.

Assuntos

RESUMO

Las masas abdominales en niños son motivo de preocupación para el pediatra, ya que plantean una interrogante sobre su naturaleza que debe estudiar y llegar a un diagnóstico en forma rápida y precisa. Entre las masas abdominales de presentación pediátrica y de naturaleza benigna se encuentran los lipoblastomas. Estos tumores son de estirpe mesenquimatosa y están constituidos por adipositos inmaduros que se localizan en las extremidades, sin embargo existen otras localizaciones como la intraabdominal. El presente caso es el reporte de un lipoblastoma mesentérico ocurrido en una niña de 1 año y 7 meses, natural de Piura y derivada por una tumoración gigante intraabdominal. Los exámenes auxiliares no fueron concluyentes, por lo que se realizó una laparotomía y extirpación del tumor, que pesó 1780 g, y la anatomía patológica reveló su naturaleza. Los lipoblastomas se clasifican como tales cuando son de presentación superficial o subcutánea, y se denomina lipoblastomatosis cuando se localizan profunda o intracavitariamente. La citogenética corresponde generalmente a alteraciones del cromosoma 8 (8q 11 13). Se tiene que establecer diagnóstico diferencial con otras tumoraciones de acuerdo a su localización, con liposarcoma, rabdomiosarcoma, etc. Y cuando su localización es intraabdominal con nefroblastoma, neuroblastoma, teratoma, etc. El tratamiento es quirúrgico. Sin embargo se registra recurrencia que va del 9 por ciento al 33 por ciento de los casos, por lo que se impone un seguimiento posterior de aproximadamente 5 años.

Assuntos

RESUMO

Se denomina quiste mesentérico a una serie de masas abdominales quísticas benignas. Son poco frecuentes. La incidencia es de 1/100000 ingresos en adultos y de 1/20000 en niños. El número de casos ha aumentado con el rciente desarrollo de la ultrasonografía y la tomografía computada. En pediatría éstas masas corresponden a linfangiomas quísticos en la mayoría de los casos, mas raramente corresponden a masas provenientes del tejido mesotelial o del epiplón (5). Se considera que los quistes retroperitoneales, mesentéricos y del omento son del mismo grupo porque derivan de la misma estructura embriológica (4). Se presenta el caso de un lactante masculino de 23 meses de edad, procedente del Edo. Zulia traído a nuestro centro asistencial por presentar dolor, aumento de volumen abdominal y pérdida de peso de un mes de evolución, y en los últimos quince días vómitos postprandiales y dificultad para evacuar. Lucía caquéctico, con un abdomen globoso (perímetro: 53 cm) a expensas de tumoración indurada, dolorosa, de bordes mal definidos en hemiabdomen izquierdo, que atravesaba la línea media. Se solicitó Rx abdominal que reveló imagen densa que rachazaba las vísceras hacia hermiabdomen derecho. Se decide practicar ultrasonografía que reporta imagen densa compatible con esplenomegalia gigante, en vista de la cual se realiza TAC de abdomen con medio de contraste oral que evidencia extensa lesión intraperineal de aspecto quístico con marcado efecto comprensivo, con desplazamiento de estructuras intestinales hacia hemiabdomen derecho y anterior. Se decide realizar laparotomía exploradora hallando: tumoración quística a tensión a nivel de la raíz del mesenterio colon transverso y curvatura mayor del estómago, de la cual se drenaron 1500cc de líquido citrino, se resecó la pared anterior del quiste y se marsupializaron los bordes; (además se realizó apendicectomía profiláctica). La biopsia reportó quiste mesentérico endotelial tipo linfagioma y líquido acelular.

Assuntos

RESUMO

Los linfangiomas quísticos abdominales son tumores benignos multiloculados poco frecuentes (2 por ciento-8 por ciento de los linfangiomas),de crecimiento lento y derivados de los vasos linfáticos. Se presentan con más frecuencia en la infancia, y la gran mayoría son diagnosticados en niños menores de cinco años. Las manifestaciones clínicas son variable aunque la distensión abdominal es el signo más frecuente. En el artículo se presenta caso de una paciente de dos años con linfangioma quístico abdominal

Assuntos

RESUMO

The mesenteric cyst is a tumor of multiple origins, that undoubtedly presents with greater frequency than that referred in published series. Nevertheless, it continues to be a rare entity. Due to absence of characteristic signs and symptoms, diagnosis is only made once these lesions have reached a size, sufficiently large to be palpable or when they cause compression on organs or neighboring structures. The cyst can present with chronic manifestations such as diffuse abdominal pain imprecisely located but associated with palpable mass, or due to complications of the cyst or due to compression of adjacent structures. Diagnosis is confirmed by imaging studies, such as the different ultrasound modalities, computed tomography (CT) scan, and magnetic resonance imaging (MRI). A differential diagnosis must be made to exclude other intra-abdominal or retro-peritoneal tumors. Optimum treatment is extirpation of the cyst. On occasion it is also necessary to remove the adjacent organ due to the impossibility of enucleating cyst. marsupialization of the cyst or drainage into peritoneal cavity, have high incidence of recurrence. Surgical treatment can be carried out by minimal invasion techniques.

Assuntos

RESUMO

Cistos de duplicaçäo entéricos säo extremamente raros em adultos e acredita-se que resultam de recanalizaçäo anormal durante a vida fetal. Os cistos säo usualmente alongados, tubulares e esféricos, que podem ocorrer em qualquer local do tubo alimentar, mas säo comuns na borda mesentérica do íleo terminal. Os cistos se apresentam como massa submucosa ou extraluminal e, usualmente, näo se enchem de bário. A demonstraçäo ultra-sonográfica de duas camadas distintas na parede da massa - uma camada interna ecogênica representando a mucosa e uma externa hipoecogênica representando o músculo - é fortemente sugestiva de cisto de duplicaçäo entérico.

Assuntos

RESUMO

Antecedentes. Los tumores quísticos del mesenterio son lesiones poco comunes, generalmente únicas, que pueden localizarse desde duodeno hasta el recto. La localización más frecuente es en el intestino delgado. Objetivo. Conocer e identificar las manifestaciones clínicas y de gabinete en los pacientes con quiste de mesenterio. Material y método. Se estudió a paciente femenino de 62 años con padecimiento de un año de evolución caracterizado por aumento del perímetro abdominal, dolor abdominal, hiporexia, astenia y adinamia. A la exploración física se corroboró tumoración abdominal. El abordaje diagnóstico incluyó radiografía simple de abdomen y tomografía computada de abdomen. Fue sometida a laparotomía exploradora con diagnóstico preoperatorio de quiste gigante de ovario izquierdo; se resecó un quiste de mesenterio a nivel de sigmoides. La evolución posoperatorio fue satisfactoria. El reporte de histopatología fue de quiste benigno de mesenterio. Conclusión. Los quistes de mesenterio son poco frecuentes. Se deben extirpar cuando presentan sintomatología abdominal importante y por la posibilidad de degeneración maligna

Assuntos