A RARE PRESENTATION OF MESENTERIC CYST

Aim: Aim is to report a case of rare presentation of mesenteric cyst i.e., infected mesenteric cyst. Mesenteric cysts are rare intraabdominal lesions of childhood. Symptoms are extremely variable and are related to the size and position of the cyst, with no pathognomonic signs in the uncomplicated patients. Mesenteric cysts may cause abdominal distension or pain. It may also present with acute symptoms secondary to complications such as obstruction (volvulus, extrinsic compression or entrapment in pelvis), rupture, and hemorrhage into cyst, infection or abscess formation. The most common acute presentation in children is small bowel obstruction with a possible volvulus and an associated intestinal infarction. Infected mesenteric cyst and/or perforation are very rare complications of a very unusual lesion. Ultrasonography (USG) and computed tomography (CT) are the best preoperative diagnostic tools. The treatment of choice is an urgent laparotomy and complete cyst removal. Case: We report a case of 16yrs old boy who presented with right iliac fossa pain. He was diagnosed clinically as an appendicular lump.USG and CT revealed a cystic mass. Laparotomy was done, which revealed a huge multiloculated cystic mass in the ileal mesentery. Resection and ileo-ileostomy was done. Conclusion: Acute presentations of the mesenteric cyst are rare and can be misdiagnosed as common abdominal diseases at presentation, such as appendicitis, ovarian torsion, diverticulitis and small bowel obstruction. USG and CT scanning are the most useful imaging modalities for diagnosing mesenteric cysts preoperatively. Surgical removal is the only treatment for these lesions.