Abstract

Case Report

Dermoid Cyst of the Mesentery of the Jejunum Following Appendectomy: A Clinical Case

Gavrilyuk VP, Severinov DA* and Zubkova YA

Published: 07 November, 2023 | Volume 7 - Issue 3 | Pages: 058-061

Mesenteric cysts and cystic mesenteric tumors are very rare abdominal growths. They may be localized all over the mesentery, from the duodenum to the rectum, however, they are mostly found in the ileum and right colon mesentery. There are several classifications of these formations, among which the one based on histopathologic features including 6 groups has been most commonly used: 1) cysts of lymphatic origin--lymphatic (hilar cysts) and lymphangiomas; 2) cysts of mesothelial origin--benign or malignant mesothelial cysts; 3) enteric cysts; 4) cysts of urogenital origin; 5) dermoid cysts; and 6) pseudocysts-infectious or traumatic etiology.
A dermoid cyst is a benign, epithelial-lined cavitary lesion composed of ectoderm and mesoderm that can arise anywhere in the body, with a tendency to develop in midline structures.
In 20% - 45% of cases, accompanying diseases that were not previously clinically manifested can be diagnosed during emergency interventions, requiring additional surgical interventions for their correction.
The aim of the study is to demonstrate the successful treatment experience of a dermoid cyst of the mesentery of the jejunum, detected after traditional appendectomy.
Clinical case:  A mother brought her 9-year-old son, V., to the emergency department of the Kursk Regional Children’s Clinical Hospital with complaints of moderate-intensity pain in the right iliac region, multiple episodes of vomiting, and fever. Ultrasound features indicative of destructive appendicitis and peritonitis. In an emergency situation, after preoperative preparation, a traditional appendectomy was performed under intravenous anesthesia, using the Volkovich-Dyakonov approach. The postoperative period was uneventful. Moderate infiltration was observed on the control abdominal ultrasound examination, in the intestine (presumably the small intestine) in the right half of the abdominal cavity, with a solid formation measuring 27*33 mm, producing a dense acoustic shadow. On the 7th day after the initial intervention, a revision of the abdominal organs was performed. The loop of the jejunum with the formation was brought out into the wound. The capsule above the formation was dissected: the formation of bone density, when the capsule is separated, resembles a fecal stone in structure, considering the localization - a dermoid cyst. Step-by-step enucleation of the cyst was performed. The postoperative wound was tightly sutured in layers.

Read Full Article HTML DOI: 10.29328/journal.acr.1001080 Cite this Article Read Full Article PDF

Keywords:

Dermoid cyst; Appendectomy; Children; Surgery

References

  1. Svensson JF, Patkova B, Almström M, Eaton S, Wester T. Outcome after introduction of laparoscopic appendectomy in children: A cohort study. J Pediatr Surg. 2016 Mar;51(3):449-53. doi: 10.1016/j.jpedsurg.2015.10.002. Epub 2015 Nov 10. PMID: 26655215.
  2. Zhang S, Du T, Jiang X, Song C. Laparoscopic Appendectomy in Children With Perforated Appendicitis: A Meta-Analysis. Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):262-266. doi: 10.1097/SLE.0000000000000411. PMID: 28472016.
  3. Zhang Z, Wang Y, Liu R, Zhao L, Liu H, Zhang J, Li G. Systematic review and meta-analysis of single-incision versus conventional laparoscopic appendectomy in children. J Pediatr Surg. 2015 Sep;50(9):1600-9. doi: 10.1016/j.jpedsurg.2015.05.018. Epub 2015 Jun 3. PMID: 26095165.
  4. Timerbulatov VM, Mekhdiev DI, Timerbulatov SV, Sagitov RB, Yamalov RA, Gaynullina EN. [Simultaneous abdominal and retroperitoneal surgery]. Khirurgiia (Mosk). 2016;(3):40-44. Russian. doi: 10.17116/hirurgia2016340-44. PMID: 27070874.
  5. Poddubny IV, Isaev AA, Ternavsky AP. Simulated laparoscopic operations in pediatric surgery. Surgeon. 2008; 12:48-57. (In Russia.).

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