Mesenteric Cyst as Inguinal Hernia, Should We Do More?

Abstract

Introduction: Mesenteric cysts are rare cystic structures found in the mesentery of the bowels, spanning from the duodenum to the colon and even into the retroperitoneum. They are infrequently encountered, with incidence rates varying from 1 in 20,000 to 1 in 350,000 hospital admissions. These cysts were first observed in the 16th century and can present with a range of clinical symptoms, from palpable abdominal masses to acute issues. A specific diagnostic feature, known as Tillaux's triad, includes the signs of a central abdomen cystic mass, the mass moving perpendicularly to its origin, and a band of resonance on percussion surrounding the cyst. Case Report: This report details a case of an incidental finding of a mesenteric cyst that initially presented as an irreducible right inguinal hernia in a one-year-old boy. The cyst was discovered during surgery and required laparotomy, cyst resection, and re-anastomosis of the intestines. Post-surgery, the child recovered well, and histopathology confirmed the diagnosis as a mesenteric cyst. Conclusion: Mesenteric cysts can have diverse presentations, and they should be considered as a potential cause of inguinal hernias in pediatric patients. Surgical excision with or without bowel resection is the standard treatment with favorable outcomes. The case underscores the importance of considering mesenteric cysts in the differential diagnosis of pediatric inguinal hernias.