A Case of Adult Mesenteric Chylous Cyst with Volvulus

Yuichi Fumimoto, Yoshifumi Inoue, Yukinobu Yoshikawa, Masaya Nomura, Hirohiko Yokotani and Shigeo Souda

Department of Surgery, Nissay Hospital, Nippon Life Saiseikai Foundaition

We report a case of adult mesenteric chylo cyst with volvulus. A 57-year-old woman admitted to another hospital for upper abdominal pain was suspected of torsion of an ovarian cyst because a 4×4.5×3 cm cystic mass was detected in the lower abdomen by transvaginal ultrasonography. In emergency surgery, we found a 8×6.5 cm mesenteric cyst in the mesentery of the jejunum about 170 cm from the anus from Treitz's ligament complicated with volvulus. The cyst was so close to the small intestine that we resected the cyst with a part of the jejunum. The cyst was filled with about 300 ml of milky, odorless fluid soluble in ether. TG in the fluid was, 5,255 mg/dl, so she was diagnosed with a mesenteric chylo cyst, histologically cystic lymphagioma. Adult mesenteric chylo cysts are very rare. We clinically review 23 cases reported in Japan, including this case.

Key words
mesenteric chylous cyst, volvulus, cystic lymphagioma

Reprint requests
Yuichi Fumimoto Department of Surgery, Nissay Hospital, Nippon Life Saiseikai Foundaition
6-3-8 Itachibori, Nishi-ku, Osaka, 550-0012 JAPAN

Accepted
February 25, 2004

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