Jejunal mesenteric cyst presenting as acute midgut volvulus in a child: a rare cause of surgical abdomen.

Abstract

Introduction: Mesenteric cysts are defined as benign intra-abdominal tumors located in the mesentery. Mesenteric cysts are rare intra-abdominal lesions in children and are often asymptomatic. Acute midgut volvulus secondary to a mesenteric cyst is an exceptionally uncommon presentation that requires prompt surgical intervention to prevent bowel ischemia.

Case presentation: An 8-year-old boy was referred from the pediatric department with acute abdominal pain and recurrent bilious vomiting. Clinical examination revealed around 20 × 20 cm size cystic lump involving whole abdomen. Contrast-enhanced computed tomography demonstrated a large mesenteric cyst associated with midgut volvulus. The patient underwent emergency exploratory laparotomy, which confirmed a huge mesenteric cyst causing volvulus of proximal jejunum. Complete excision of the cyst along with resection of the involved bowel segment was performed, followed by primary bowel anastomosis. The postoperative course was uneventful, and the patient recovered well.

Conclusion: Mesenteric cysts may rarely present as a surgical emergency due to volvulus, intestinal obstruction, or bowel ischemia. Early recognition and timely surgical management are essential for favorable outcomes.