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British Journal of Healthcare and Medical Research - Vol. 10, No. 6
Publication Date: December 25, 2023
DOI:10.14738/bjhmr.106.15885.
Romero-Briones, C. G., Ponciano-Guerrero, M., Ramírez-Vázquez, J. L., Flores-García, A. E., Montenegro-Jiménez, C., & Martínez- Romero, J. A. (2023). Mesocolon Cyst, Case Report and Literature Review. British Journal of Healthcare and Medical Research, Vol -
10(6). 82-86.
Services for Science and Education – United Kingdom
Mesocolon Cyst, Case Report and Literature Review
Romero Briones, Carlos Gabriel
General Surgery Department Specialty Hospital
“Manuel Ávila Camacho” IMSS, Puebla, Puebla, Mexico
Ponciano Guerrero, Mateo
General Surgery Department Specialty Hospital
“Manuel Ávila Camacho” IMSS, Puebla, Puebla, México
Ramírez-Vázquez, José Luis
General Surgery Department Specialty Hospital
“Manuel Ávila Camacho” IMSS, Puebla, Puebla, Mexico
Flores-García, Alba Elda
General Surgery Department Specialty Hospital
“Manuel Ávila Camacho” IMSS, Puebla, Puebla, Mexico
Montenegro-Jiménez, Carolina
General Surgery Department Specialty Hospital
“Unidad Médica de Alta Especialidad 71 Torreón, Coahuila”, Mexico
Martínez-Romero, José Alfonso
General Surgery Department Specialty Hospital
“High Specialty Medical Unit 71 Torreón, Coahuila”, Mexico
ABSTRACT
Introduction: They commonly originate in the mesentery of the small intestine
(70%), although a proportion has been found to originate in the mesocolon (24%)
and the retroperitoneum (14.5%). Clinical case: 58-year-old female patient. The
intervention was performed by performing exploratory laparotomy, dissecting by
planes, cavity with no signs of tumor activity, exposure of the sigmoid colon,
following its hilum, a tumor was found in the mesentery, the cyst measuring 150 x
130 mm. solid cystic appearance. Discussion: A definitive diagnosis is established
through surgical excision and with a definitive study such as histopathological
examination of the tumor. All of these considerations were taken into account in the
management of our case. Conclusions: Regarding the sigmoid mesocolon cyst, it is a
rare and mostly benign pathology, with an asymptomatic course and if symptoms
are present, it is not very specific, and therefore there is a delay in the diagnosis.
Keywords: Mesocolon, cyst, mesentery, exploratory laparotomy.
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Romero-Briones, C. G., Ponciano-Guerrero, M., Ramírez-Vázquez, J. L., Flores-García, A. E., Montenegro-Jiménez, C., & Martínez-Romero, J. A.
(2023). Mesocolon Cyst, Case Report and Literature Review. British Journal of Healthcare and Medical Research, Vol - 10(6). 82-86.
URL: http://dx.doi.org/10.14738/bjhmr.106.15885.
INTRODUCTION
As important antecedents, we have that in 1842 the first mesentery cyst was reported and 10
years later the first omentum cyst (1). These can be present throughout the intestinal tract;
they can be located from the duodenum to the rectum. They commonly originate in the
mesentery of the small intestine (70%), although it has been found that a proportion originates
in the mesocolon (24%) and the retroperitoneum (14.5%). (2) Performing a thorough physical
examination and performing radiological investigations such as ultrasound and CT scan are the
key to diagnosis. A mesenteric cyst originating from the sigmoid mesocolon is a very rare
finding (2, 3). Most often, cysts are located in the mesentery of the small intestine. They usually
occur during the first decade of life, occurring mainly in pediatric patients. These lesions
characteristically arise from the mesenteric border of the intestine. (3)
CLINICAL CASE
This is a 58-year-old female patient, with no known personal history, who consulted for an 8-
month history of abdominal pain, weight-type pain of mild intensity located in the left flank and
iliac fossa without reporting weight loss. changes in evacuation habits or any associated
symptoms. He went to a private doctor who, due to his symptoms and evolution, requested
paraclinical tests (hematic biometry, blood chemistry, liver function tests, tumor markers),
which were found within normal parameters and, in addition, a total abdominal ultrasound was
requested, which reported a passive lesion lodged in the left iliac fossa in relation to the sigmoid
colon, measuring 150 x 140 x 90 mm, non-septate, without presence of vascularization, without
evidence of free fluid or any additional alteration. Given these findings, it was decided to
perform an abdominal CT scan as a complementary study. The report of the simple and
contrasted abdominopelvic tomography, which showed the presence of a voluminous
collection that projected to the sigmoid colon, which displaced the ipsilateral colon and kidney
with a homogeneous content, not septum, 8mm wall, without enhancement of contrast
medium, without invasion to other structures, with regular edges, in its largest diameters with
measurements about 130 x 100 x 90 mm for an approximate volume of 160 ml, liver, pancreas,
spleen, normal intestinal loops, kidneys and system normal excretory. With the above findings,
a diagnostic conclusion of mesenteric cyst was reached, for which the patient was scheduled
for a surgical procedure.
Figure 2: tumor of soft consistency, with well-defined edges, dependent on mesocolon, loose
adhesions between mesocolon fatty tissue and between cyst, with the presence of poor
vascularization, not shown with any other adjacent organ.
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British Journal of Healthcare and Medical Research (BJHMR) Vol 10, Issue 6, December- 2023
Services for Science and Education – United Kingdom
An exploratory laparotomy was performed, dissecting in planes, a cavity with no evidence of
tumor activity, exposure of the sigmoid colon, following its hilum, a tumor was found in the
mesentery, the cyst measuring 150 x 130 mm with a solid cystic appearance (Figure 2) without
create adhesions to surrounding structures, so the Mattox maneuver is performed , with
subsequent exteriorization of the left hemicolon , dissection is carried out up to the hilum of the
cyst, With subsequent ligation with 2-0 vicryl , after ligation there was no evidence of
involvement of the sigmoid colon or upper portion of the rectum. Intestinal loops were
reintroduced and the cavity was closed in planes, with the placement of a Penrose-type drain
aimed at the pelvic cavity with a counter opening on the left flank. His post-surgical evolution
was adequate and he was discharged 3 days after the surgical procedure. Outpatient post- surgical control was performed after 2 months, and follow-up after one year for a period of
three years without evidence of recurrence.
The final pathology report reported:
Surgical piece with anatomical components relationship to cyst, (figure 4) without infiltration
of adjacent structures, comprising at the base multiple cysts of variable size, predominantly
collapsed, without infiltration of underlying fat, collagen septa separating the cysts.
Figure 4: Non-septated mesocolon cyst. The lesion comprises multiple cysts of variable size,
predominantly collapsed in the basal part. No underlying fat infiltration. It is lined by flattened
mesothelial cells with soft nuclei. The cyst wall was lined by tall, mucin-secreting columnar
cells with lymphomononuclear infiltrate.
DISCUSSION
Mesenteric cysts have a low incidence worldwide, approximately 1 in 100,000 adults seeking
medical care, and primarily affect people in their second to third decades of life. (1) These
lesions can affect any part of the mesentery and account for 7% of all abdominal cysts. These
lesions exhibit primarily benign characteristics, but up to 3% of these lesions may be malignant
(2).
The etiopathogenesis of the tumors has not been established but there are numerous theories
regarding the formation of mesentery and omentum cysts, including benign proliferation of