Missoki Azanlédji Boume1*, Ayi Kossigan Adodossi Amavi2, Komlan Adabra2, Komlan Anani Mihluedo-Agbolan1, Sessime Yawa Sanni1, Serge Codjo Metchihoungbe1, Gamedzi1 and Komlatsè Akakpo-Numado1
1Department of Paediatric Surgery, Sylvanus Olympio Teaching Hospital, BP 57 Lomé, Togo
2Department of General Surgery, Sylvanus Olympio Teaching Hospital, BP 57 Lomé, Togo
Background: Cystic lymphangiomas (CL) are congenital benign malformations of lymphatic vessels. Their usual locations (90%) are neck and axilla in subcutaneous tissue. Abdominal locations are rare and represent 10-12%. The incidence of mesenteric and omental cysts is 1 in 20,000 among children, and even lower among infants. Only 2.2% are omental cysts of these two types of cystic mass. Of omental CL, unilocular forms are rarer but more common in boys than in girls. We aim to present clinical, radiological and therapeutic management of a small omental unilocular CL, slowly evolved in a girl.Observation: A girl of 4-years suffered of chronic intermittent abdominal pain without vomiting and fever, managed like parasitic infection during a year. One year after, appears an abdominal swelling leading to pediatric surgery department. There was no prenatal diagnosis. The preoperative radiological diagnosis by ultrasonography and scan was simple mesenteric cyst, especially because of the unilocular presentation aspect. One week before scheduled surgery it was complicated by intracystic hemorrhage. The lesion of 17 cm × 8 cm was implanted in the small omentum under the liver between hepatic pedicle and the gastric artery. It had sero-hematic content and was totally removed by laparotomy. Hystological examination concluded to CL. The outcome was favorable after 13 months follow up.Conclusion: CL has many forms, locations and cystic contents. Unilocular cystic lymphangiomas located in the small omentum are very rare and can be complicated at any time. It is more often confused with mesenteric cysts but they are distinct from one another by pathological examination which gives the final proof of the diagnosis. Surgical resection should be as complete as possible, putting the patient free from recurrences.
Cystic lymphangioma; Abdomen; Omentum ; Children; Surgery
Boume MA, Amavi AKA, Adabra K, Mihluedo-Agbolan KA, Sanni SY, Metchihoungbe SC, et al. Unilocular Cystic Lymphangioma of the Small Omentum in a Girl of 4 Years. Clin Surg. 2017; 2: 1487.