Imaging Department

June 26th, 2012 Reported by Dr. Giang

Name: Chu Xuan Hiep Sex: Male Age: 4 years old. Dept: A5

Clinical

Abdominal pain Mild fever Vomiting Palpable abdominal mass.

MRI Findings(T2WI, Axial, Pre C+)

Well-define large cystic mass distend from Right upper quadrant abdomen to the pelvic (12,5 x5,8 cm)

Hyperintense signal (homogenous)

MRI Findings(T2 FS, Coronal, Pre C+)

Hyperintense Compress & displace Bowel loops to

the Left Hypointense structure pass throw

the Cyst.

MRI Findings(T1W, Axial, Pre C+)

Hypointense signal = water signal

MRI Findings(T1W, Coronal, Post C+)

Multiseptations intracyst: thin & mild enhance post C+

Structrure pass throw the cyst: enhance like bowel.

MRI Findings(T1W, Axial, Post C+)

Multiseptations intracyst: thin & mild enhance post C+

US Findings

Large cystic mass with multi- thin septations (> 12,5 cm)

Hypogenic, fluid filled cyst. Bowel loop pass throw the cyst.

Diagnosis

Mesenteric Cystic Lymphangioma

Background1. Definition:

Mesenteric Cystic Lymphangioma: A cystic mass arising in the mesentery or omentum, not from an abdominopelvic organs

2. Location: Occur anywhere in the mesentery or omentum

3. Size: Few mm to 40 cm in diameter

4. Age: Children and young adults; 33% < 15 years of age

5. Epidemiology: Rare 1/140,000 in general admission, 1/20,000 in pediatric admission

Background6. Complication: Intestinal obstruction, volvulus,

hemorrhage, rupture, infection, sepsis, cystic torsion and obstruction of the urinary and biliary tract

7. Treatment: Enucleation of cyst ± bowel resection

8. Prognosis: Good after surgery, 0-13.6% recurrence rate

Thank you for attention!