Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2015.026
Autopsy and Case Reports
Article / Clinical Case Report

Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients

Bianca Furlan Fernandes; Érika Neves de Souza Moraes; Francini Rossetto de Oliveira; Gabriel Núncio Benevides; Aloísio Felipe-Silva; Cristiane Rúbia Ferreira; Paulo Sérgio Martins de Alcântara; Flavio Tokeshi; João Augusto dos Santos Martinês; Ângela Espósito Ferronato

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Abstract

Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman’s colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients.
 

Keywords

Lymphangioma, Cystic, Colon, Sigmoid, Abdomen, Acute, Surgical Procedure, Operative

References

Farrell WJ, Grube P. Intra-abdominal cystic lymphangiomas. Am J Surg. 1964;108(6):790-3. [https://doi.org/10.1016/0002-9610(64)90033-9]. [PMID:14233758]

Sencan A, Akçora B, Mir E. The association of jejunal atresia and cystic lymphangioma in the same location. J Pediatr Surg. 2003;38(8):1255-7. [https://doi.org/10.1016/S0022-3468(03)00283-5]. [PMID:12891508]

Godart S. Embryological significance of lymphangioma. Arch Dis Child. 1966;41(216):204-6. [https://doi.org/10.1136/adc.41.216.204]. [PMID:5948671]

Kosir MA, Sonnino RE, Gauderer MWL. Pediatric abdominal lymphangiomas: a plea for early recognition. J Pediatr Surg. 1991;26(11):1309-13. [https://doi.org/10.1016/0022-3468(91)90607-U]. [PMID:1812264]

Perrot M, Rostan O, Morel P, Le Coultre C. Abdominal lymphangioma in adults and children. Br J Surg. 1998;85(3):395-7. [https://doi.org/10.1046/j.1365-2168.1998.00628.x]. [PMID:9529502]

Levy AD, Cantisani V, Miettinen M. Abdominal Lymphangiomas: imaging features with pathologic correlation. Am J Roentgen. 2004;182(6):1485-91. [https://doi.org/10.2214/ajr.182.6.1821485]. [PMID:15149994]

Ko S-F, Ng SH, Shieh C-S, Lin J-W, Huang C-C, Lee T-Y. Mesenteric cystic lymphangioma with mixoid degeration: unusual CT and MR manifestations. Pediatr Radiol. 1995;25(7):525-7. [https://doi.org/10.1007/BF02015784]. [PMID:8545181]

Elliott GB, Kliman MR, Elliott KA. Persistence of lymphaticovenous shunts at the level of the microcirculation: their relationship to “lymphangioma” of mesentery. Ann Surg. 1970;172(1):131-6. [PMID:5448503]

Galifer RB, Pous JG, Juskiewenski S, Pasquie M, Gaubert J. Intra-abdominal cystic lymphangiomas in childhood. Prog Pediatr Surg. 1978;11:173-238. [PMID:343178]

Gyves-Ray K, Hernandez RJ, Hillemeier AC. Pseudoascites: unusual presentation of omental cyst. Pediatr Radiol. 1990;20(7):560-1. [https://doi.org/10.1007/BF02011393]. [PMID:2216595]

Walker AR, Putnam TC. Omental, mesenteric, and retroperitoneal cysts: a clinical study of 33 new cases. Ann Surg. 1973;178(1):13-9. [https://doi.org/10.1097/00000658-197307000-00003]. [PMID:4717705]

Lestache JG, Ollero JM, Rollan V. Les lymphangiomes kystiques intra-abdominaux. Chir Pediatr. 1980;21(2):155-9. [PMID:7448984]

Oliver GA. The omental cyst: a rare cause of the acute abdominal crisis. Surgery. 1964;56:373-6. [PMID:14217616]

Kim BS, Sbar AS, Jatoi I. Intra-abdominal cystic lymphangioma. Surgery. 2000;128(5):834-5. [https://doi.org/10.1067/msy.2000.108116]. [PMID:11056448]

Handelsman JC, Ravitch MM. Chylous cysts of the mesentery in children. Ann Surg. 1954;140(2):185-93. [https://doi.org/10.1097/00000658-195408000-00006]. [PMID:13181333]

Brancatelli G, Cusma S, Midiri M. Cystic lymphangioma of the retroperitoneum. Urology. 2000;55(2):283. [https://doi.org/10.1016/S0090-4295(99)00402-1]. [PMID:10688095]

Zhuo CH, Shi DB, Ying MG, et al. Laparoscopic segmental colectomy for colonic lymphangiomas: a definitive, minimally invasive surgical option. World J Gastroenterol. 2014;20(26):8745-50. [https://doi.org/10.3748/wjg.v20.i26.8745]. [PMID:25024636]

Gephart HR, Cherry JK. Omental lymphangioma masquearing as ascites. Am J Surg. 1968;115(6):861-3. [https://doi.org/10.1016/0002-9610(68)90536-9]. [PMID:5649845]

Hancock BJ, St-Vil D, Luks FI, Lorenzo MD, Blanchard H. Complications of Lymphangiomas in children. J Pediatr Surg. 1992;27(2):220-46. [https://doi.org/10.1016/0022-3468(92)90316-Y]. [PMID:1564622]

Aly HF. Abdominal cystic lymphangioma in children. Ann Pediatr Surg. 2009;5(2):132-6.

Engel S, Clagett OT, Harrison EG Jr. Chylous cysts of the abdomen. Surgery. 1961;50:593-9. [PMID:13890225]

Iyer R, Eftekhari E, Varma D, Jaffe N. Cystic retroperitoneal lymphangioma: CT, ultrasound and MR findings. Pediatr Radiol. 1993;23(4):305-6. [https://doi.org/10.1007/BF02010922]. [PMID:8414761]

Takiff H, Calabria R, Yin L, Stabile BE. Mesenteric cysts and intra-abdominal cystic lymphangiomas. Arch Surg. 1985;120(11):1266-9. [https://doi.org/10.1001/archsurg.1985.01390350048010]. [PMID:4051731]

Allen JG, Riall TS, Cameron JL, Askin FB, Hruban RH, Campbell KA. Abdominal lymphangiomas in adults. J Gastrointest Surg. 2006;10(5):746-51. [https://doi.org/10.1016/j.gassur.2005.10.015]. [PMID:16713549]


 


Publication date:
01/13/2016

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