Chylous Mesenteric Cyst: A Rare Surgical Entity—A Case Report From Nepal

TL;DR

A rare case of chylous mesenteric cyst in a 54-year-old man was successfully treated with minimally invasive surgery in Nepal.

Contribution

This case report highlights the successful laparoscopic management of a rare chylous mesenteric cyst.

Findings

The patient presented with a large chylous mesenteric cyst containing 700 mL of chylous fluid.

Laparoscopic excision and ureteric stenting led to a favorable post-operative outcome.

Histopathology confirmed the diagnosis of a chylous mesenteric cyst.

Abstract

Chylous Mesenteric Cyst is an uncommon benign abdominal cyst that can arise anywhere along the mesentery of the gastrointestinal tract, from the duodenum to the rectum. It is often asymptomatic but can rarely present with abdominal discomfort or a palpable abdominal mass. Final diagnosis typically relies on histopathology examination following laparoscopic or open excision. We present a 54 years old male who initially presented with right lower abdominal discomfort and lump. Computed Tomography (CT) demonstrated a large thin walled cystic lesion abutting and displacing the right ureter. Pre‐operative ureteric stenting and laparoscopic excision of the cyst was planned. The cyst contained 700 mL of chylous fluid and was excised in toto. Histopathological examination was consistent with chylous mesenteric cyst. The ureteric stent was removed at the end of surgery. The patient was discharged with favorable outcome in second post‐operative day. Mesenteric cysts are rare entities and appropriate planning is essential for a favorable outcome. Our case report demonstrates successful management of this rare condition with the use of minimally invasive surgery.

Chylous mesenteric cysts are benign abdominal cysts that can occur along the mesentery of the gastrointestinal tract. Often asymptomatic, they may present as a palpable mass. Diagnosis is confirmed through histopathology, with excision considered the gold standard. We present a rare case of mesenteric cyst successfully managed with minimally invasive surgery.

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