title: Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.
abstract: Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia. Emergency laparotomy revealed a mass in the mid-jejunal mesentery close to the bowel wall with no bowel ischaemia. The patient made an uncomplicated recovery after segmental bowel resection and end-to-end anastomosis. Histology confirmed the mass as a cystic lymphangioma involving the jejunal mesentery and two small jejunal polyps. Lymphangioma could be considered in the differential diagnosis of an acute abdomen in a young adult when the presentation is atypical.
authors.affiliation: Colombo South Teaching Hospital Kalubowila , Sri Lanka.
authors.forename: Jasb
authors.initials: J
authors.lastname: Jayasundara
authors.affiliation: Lanka Hospital , Colombo , Sri Lanka.
authors.forename: E
authors.initials: E
authors.lastname: Perera
authors.affiliation: Queen Elizabeth Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust , Colombo , Sri Lanka.
authors.forename: M V
authors.initials: MV
authors.lastname: Chandu de Silva
authors.affiliation: Colombo South Teaching Hospital Kalubowila , Sri Lanka.
authors.forename: A A
authors.initials: AA
authors.lastname: Pathirana
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000293:Adolescent; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D007580:Jejunal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D007583:Jejunum; D018191:Lymphangioma, Cystic / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008643:Mesentery / Q000000981:diagnostic imaging* / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Cystic lymphangioma; Jejunal lymphangioma; Mesenteric lymphangioma