title: Early management of mesenteric cyst prevents catastrophes: a single centre analysis of 17 cases.
abstract: BACKGROUND
  Mesenteric cysts are rare intra-abdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal symptoms.
  
  
  METHODS
  Seventeen patients (age less than 10 years) with mesenteric cysts were managed in our hospital. The age ranged from 15 days to 10 years. Patients were admitted with acute or chronic symptoms. They were evaluated with complete history, clinical examination, blood investigations and radiological investigations (x-ray abdomen erect, ultrasound abdomen (USG) and computed tomography (CT) scan in selected cases) to reach a provisional diagnosis. The diagnosis was proven on laparotomy and histologically confirmed.
  
  
  RESULTS
  The main presenting symptoms were abdominal pain or lump. The most common mode of presentation was acute small intestinal obstruction. USG was not conclusive in all. Abdominal CT scan with intravenous contrast was diagnostic in nine patients. Five patients had volvulus on exploration. Cysts were located in small intestinal mesentery in 14 cases and three were in the sigmoid mesentery. Seven patients had complete excision, intestinal resection was required in four and marsupialisation with cauterisation of margins was done in six patients. Histologically, all were lymphangiomatous mesenteric cysts.
  
  
  CONCLUSIONS
  The diagnosis of mesenteric cysts should be kept in mind in any patient presenting with acute abdominal symptoms. Small bowel volvulus with mesenteric cyst constituted a significant number in children with acute abdominal symptoms. Early diagnosis and treatment yields excellent outcome.
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India. drprakashadvait@rediffmail.com
authors.forename: Advait
authors.initials: A
authors.lastname: Prakash
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Rahul K
authors.initials: RK
authors.lastname: Gupta
authors.forename: Beejal
authors.initials: B
authors.lastname: Sanghvi
authors.forename: Sandesh
authors.initials: S
authors.lastname: Parelkar
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D008639:Mesenteric Cyst / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed