A Case of Infected Mesenteric Pseudocyst of the Transverse Colon

Toshihiko Waku and Kazuhiko Watanabe

Department of Surgery, Central Hospital

A 43-year-old woman admitted with a 2-week history of right abdominal pain and fever was found in abdominal ultrasonography (US) and computed tomography (CT) to have a homogeneous cystic mass about 13 cm in diameter. Physical examination showing severe abdominal pain with muscular defense a day after admission necessitated emergency surgery. A large tumor arising from the transverse mesocolon had tightly adhered to the transverse colon, necessitated segmental resection of the transverse colon and the mesocolon containing the tumor. The tumor was an unilocular cyst 15× 12× 10cm containing an obnoxious brown purulent fluid. Microscopically, the cyst wall consisted of a thick, fibrous tissue, involving fat tissue, and neutrophil infiltration, but no specific endothelial lining was detected in the cyst wall or fluid. No communication was seen between the transverse colon and the tumor. These findings suggest that the cyst was an infected pseudocyst of the mesentery. Infected pseudocysts with the onset of acute peritonitis are extremely rare, and have not, to our knowledge, been previously reported in Japan.

Key words
inefcted mesenteric cyst, pseudocyst, mesentery of the transverse colon

Reprint requests
Toshihiko Waku Department of Surgery, Central Hospital 7-3 Sumiyoshi-cho, Fukuyama city, 720-0809 JAPAN

Accepted
October 30, 2002

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