Volvulus of small intestine: rare complication of mesenteric pseudocyst.
OBJECTIVE
Mesenteric cyst is a rare intra-abdominal lesion. Most patients with mesenteric cysts are asymptomatic. Symptomatic mesenteric cysts are associated with cyst size, cyst location, and complications, including infection, rupture, hemorrhage, and intestinal obstruction. Volvulus is a rare complication of mesenteric cyst.


METHODS
We report a 50-year-old woman with colicky epigastric pain for three days. The symptoms exacerbated in the supine position and were relieved in the sitting position. Computed tomography of her abdomen revealed a huge cystic lesion with a whirl sign of mesentery vessels. She had the history of gastro-esophageal reflux disease.


RESULTS
Segmental resection of the small intestine with end-to-end anastomosis was performed. Histology indicated a hemorrhagic pseudocyst. The patient recovered well after surgery.


CONCLUSIONS
Mesenteric pseudocyst rarely results in volvulus of small intestine. Our case is the eleventh case reported in the English literature. Atypical presentation of epigastric pain while lying down may lead to mis-diagnosis. This case reminds the clinicians this rare complication.
Fan
H-L
HL
Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chen
T-W
TW
Hong
Z-J
ZJ
Hsieh
C-B
CB
Chan
D-C
DC
Chen
C-J
CJ
Liu
Y-C
YC
Yu
J-C
JC
D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008639:Mesenteric Cyst / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D011859:Radiography; D035583:Rare Diseases; D016896:Treatment Outcome