When a lymphatic malformation determines a bowel volvulus: Are clinical status and images always reliable?. (2016)

• Record Type: Journal Article
• Authors: Guida, Edoardo; Di Grazia, Massimo; Cattaruzzi, Elisabetta; Bussani, Rossana; Rigamonti, Waifro; Lembo, Maria Antonietta
• Is Part Of: International journal of surgery case reports. Volume 25(2016)
• Page Start: 192
• Page End: 195
• Publication Date: 2016
• Subjects: CT computed tomography -- US ultrasonography -- MRI magnetic resonance -- LM lymphatic malformation; Acute abdomen -- Children -- Lymphatic malformation; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.06.030
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Small-bowel volvulus could be a presentation of a cystic mesenteric LM. Diagnosis could be intraoperative. Complete excision including, in some selected cases, a bowel resection, should be the treatment of choice. Abstract: Introduction: An acute abdomen in the form of small-bowel volvulus could be a presentation of a lymphatic malformation in childhood. Case presentation: A 5 year old male was admitted to our Institute for an acute abdomen. Clinical aspects and radiological images were not specific for a certain diagnosis. Laparotomy revealed a big soft mass, with a milky content, completely involving about 50 cm of ileus with a partial volvulus of the intestinal loop. A complete mass excision and also a bowel involved resection were performed. After a histological examination, a lymphatic malformation was diagnosed. Discussion: The diagnosis of a mesenteric lymphatic malformation could be intraoperative and a complete resection should be the treatment of choice. Sometimes it could be necessary to perform an involved bowel tract resection in the case of volvolus with ischemia. Conclusions: Paediatricians and surgeons should bare in mind that an intrabdominal lymphatic malformation may present as a nonspecific an acute abdomen caused by a bowel volvolus and diagnosis may not be so simple preoperatively.