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  • Title: Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.
    Author: Jayasundara J, Perera E, Chandu de Silva MV, Pathirana AA.
    Journal: Ann R Coll Surg Engl; 2017 Mar; 99(3):e108-e109. PubMed ID: 28252346.
    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.
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