Abstract | HISTORY AND CLINICAL FINDINGS: A 17-year-old male sought medical attention for right lower abdominal pain. At clinical examination an abdominal mass in the right lower abdominal quadrant was accompanied by pain and tenderness in this very region. The febrile patient (temperature axillary: 37.5 °C, rectal: 38.6 °C) was in reduced general health. INVESTIGATIONS: Except for an elevated C-reactive protein (CRP: 14.3 mg/dl, normal: < 0.5) laboratory tests were inconspicuous. Abdominal ultrasound showed a hypoechogenic/anechogenic septated mass measuring 7.2 × 10.4 × 15 cm as well as small amounts of fluid. Abdominal computed tomography confirmed these findings. Radiographically there was evidence for appendicitis. TREATMENT AND COURSE: Empiric antibiotic therapy was immediately commenced. Within 48 hours laparotomy was performed showing an abdominal mass which seemed to infiltrate the transverse colon, the ileocolic artery and the mesenteric root. No signs of appendicitis were found. A radical resection of the abdominal mass was performed meeting current standards of oncologic surgery. The postoperative course was favourable. Histopathological investigation showed a mesenteric cyst incorporating a hematoma and tissue with signs of chronic inflammation and granulation. CONCLUSION:
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Authors | A Blanco, C Sonntag, A Giese |
Journal | Deutsche medizinische Wochenschrift (1946)
(Dtsch Med Wochenschr)
Vol. 138
Issue 19
Pg. 995-8
(May 2013)
ISSN: 1439-4413 [Electronic] Germany |
Vernacular Title | Rechtsseitige Unterbauchschmerzen--die üblichen Verdächtigen? Diagnose und Therapie einer symptomatischen Mesenterialzyste. |
PMID | 23633278
(Publication Type: Case Reports, English Abstract, Journal Article)
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Copyright | © Georg Thieme Verlag KG Stuttgart · New York. |
Topics |
- Abdomen, Acute
(etiology, pathology, surgery)
- Adolescent
- Anastomosis, Surgical
- Antibiotic Prophylaxis
- Appendectomy
- Appendicitis
(diagnosis)
- Appendix
(pathology)
- Colectomy
- Colon
(surgery)
- Diagnosis, Differential
- Hematoma
(diagnosis, pathology, surgery)
- Humans
- Ileum
(surgery)
- Male
- Mesenteric Cyst
(diagnosis, pathology, surgery)
- Peritonitis
(diagnosis, pathology, surgery)
- Tomography, X-Ray Computed
- Ultrasonography
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