Mesenteric Lymphangioma Complicated by Small-Bowel Volvulus in a Child: A Case Report and Review of the Literature.

INTRODUCTION: Mesenteric lymphangioma is a rare cystic lesion that may present as acute abdomen due to events such as axial torsion. This is a case report of a small bowel mesenteric lymphangioma presented with axial torsion, which required emergency surgery after repeated abdominal symptoms and hospital visits failed to identify the lesion. This report includes a review of the literature.

CASE PRESENTATION: A 7-year-old boy was presented with abdominal pain and vomiting. Abdominal ultrasound and contrast-enhanced CT revealed the whirlpool sign, leading to a diagnosis of small bowel volvulus. Emergency surgery was performed. A multilocular cyst measuring approximately 8 cm in diameter was identified in the mesentery of the small bowel, approximately 150 cm proximal to the ileocecal junction. The mesentery exhibited volvulus. A partial small bowel resection and cystectomy were performed. Pathological examination revealed irregularly dilated lymphatic lumens with endothelial cells positive for CD31 and D2 - 40, resulting in a diagnosis of mesenteric lymphangioma.

CONCLUSIONS: Surgical resection is the standard treatment for mesenteric lymphangioma. Even when symptoms improve with conservative management, this disease carries the potential for serious complications requiring emergency surgery. Therefore, patients presented with abdominal symptoms, this condition should be considered, and early intervention should be contemplated.