title: An unusual cause of paediatric abdominal pain: Mesenteric masses accompanied with volvulus.
abstract: OBJECTIVE
  Volvulus caused by mesenteric masses is rare and may result in serious consequences. This study aimed to better characterize volvulus caused by mesenteric masses in children.
  
  
  METHODS
  A retrospective study was conducted in 24 patients who underwent surgical treatment between January 1994 and January 2014 in one single institution.
  
  
  RESULTS
  There were 10 boys and 14 girls. The most frequent findings were abdominal pain (100%), emesis (91.7%) and nausea (83.3%). Physical examination showed positive ileus signs in majority cases, and palpable mass was found in half of the patients. Ultrasound and CT scans revealed mesenteric masses in 21 and 24 patients, and 'whirlpool sign' was observed in 19 and 22 patients, respectively. Emergency laparotomy was performed in all patients. Histological examination revealed that 18 cystic masses were lymphangioma, 5 solid cases were lipoma and the remaining one was lipoblastoma. The postoperative course was uneventful in 22 patients, and postoperative obstruction and incision infection occurred in 2 patients. There was no evidence of recurrence at follow-up.
  
  
  CONCLUSIONS
  Volvulus caused by mesenteric masses is a rare but potentially life-threatening cause of abdominal pain, which should be considered in the differential diagnosis of paediatric acute abdominal pain.
authors.affiliation: Department of Pediatric Surgical Oncology; Ministry of Education Key Laboratory of Child Development and Disorders, The Children's Hospital of Chongqing Medical University, Chongqing, China. surgli@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Yang
authors.forename: Shan
authors.initials: S
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Xiang Ru
authors.initials: XR
authors.lastname: Kong
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Zhao
authors.forename: Chang Chun
authors.initials: CC
authors.lastname: Li
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D045822:Intestinal Volvulus / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography