Retroperitoneal, Mesenteric and Omental Cysts

Jang, Young Moon; Kim, Ki Fa; Jung, Sung Hoo; Hwang, Yong; Kang, Nam Poo

Abstract

Retroperitoneal, mesenteric, and omental cysts are rare intra-abdominal tumors. The most common symptom and physical finding is abdominal pain and a smooth, nontender, mobile, palpable mass. With increasing availability of ultrasound and computed tomography, the preoperative diagnosis of intra-abdominal cyst is being made more frequently. The upper gastrointestinal(GI) series, barium enema, and intravenous pyelogram exclude GI and genitourinary cysts and tumors. However, in the past, the correct preoperative diagnosis was made in only 25% of the other previously reported cases. Complete enucleation of the cyst, including a bowel resection, if necessary, is the treatment of choice and it has excellent postoperative results. In this study, the records of 15 patients with retroperitoneal, mesenteric, and omental cysts who underwent surgery at Chonbuk National University Hospital between January 1975 and July 1997 were retrospectively reviewed. The results are as follows: 1) The peak age was past the 4th decade (53.3%), and sex ratio of females to males was 6.5 : 1. 2) An abdominal palpable mass and abdominal pain existed in 10 cases (66.6%) and 5 cases (33.3%), respectively. Other clinical symptoms were abdominal distention, nausea, vomiting, constipation, diarrhea, fever, urinary frequeny. 3) The cyst was located on small bowel mesentey in 5 cases (33.3%), transverse colon mesentery in 4 cases (27%), retroperitoneurn in 2 cases (13%), and omentum in 2 cases (13%), and most cases were single. 4) Ultrasonography and computed tomography were helpful to know the presence of intra-abdominal mass and its location and relationship to adjacent organs. 5) The most common operation methods was complete enucleation of the cyst and next best alternative would be excion of the cyst with the resection of a portion of the adjacent bowel.