MESENTERIC CYST IN CHILD

THE CAREFUL LOOK OF THE ULTRASONOGRAPHIST

Abstract

INTRODUCTION: The mesenteric cyst is one of the rarest abdominal tumors, with approximately 820 cases reported since 1507. The lack of clinical features and characteristic radiological signs can present major diagnostic difficulties. OBJECTIVE: describe the clinical manifestations in a patient with a mesenteric cyst and the route to diagnosis. CASE REPORT: Two-year-old female patient, with no comorbidities complaining of abdominal pain, mainly in iliac fossae, associated with intense vomiting and sporadic fever spikes for about three months. Globose and painless abdomen without visceromegaly or masses. Abdominal ultrasound showed a collection of thin walls and anechoic content with minimal debris in suspension in the supravesical and hypogastric region. Laboratory tests with leukocytosis. As the symptoms intensified a tomography of the total abdomen was prescribed, which showed a voluminous, well-defined contoured cystic lesion, measuring approximately 12 x 6 cm of intraperitoneal location, occupying the lower half of the abdomen. The lesion presented septations in its anterosuperior aspect, left with a mass effect on the adjacent structures, with displacement of intestinal loops, but apparently with cleavage planes and with small free liquid in the peritoneal sac bottom, without retroperitoneal or pelvic lymph node enlargement and presence of massive ascites. The patient underwent diagnostic exploratory laparotomy, which showed a giant mesenteric cyst at the root of the mesocolon, which was excised. CONCLUSION: The mesentery cyst is the main clinical manifestation of abdominal pain associated with vomiting. Its diagnosis is difficult to conclude and may require special attention from ultrasound. If the doubt persists, tests of greater accuracy should be indicated. The role of the ultrasonographer goes far beyond the application of systematics in conducting exams. He needs to correlate radiological images with the association of possible clinical diagnoses and leverage all possible hypotheses to elucidate and facilitate the final diagnosis.