Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9990-9996
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9990
Extensive abdominal lymphangiomatosis involving the small bowel mesentery: A case report
Ayman S Alhasan, Tareef S Daqqaq
Ayman S Alhasan, Tareef S Daqqaq, Department of Radiology and Medical Imaging, College of Medicine Taibah University, Madinah 42353, Saudi Arabia
Author contributions: Alhasan AS reviewed the literature, performed the radiological interpretation, and wrote the manuscript; Daqqaq TS prepared the figures and contributed to manuscript drafting; All authors read and approved the final manuscript.
Informed consent statement: A written consent for publication was obtained from the patient for all potentially identifiable clinical data and accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ayman S Alhasan, MD, Assistant Professor, Department of Radiology and Medical Imaging, College of Medicine Taibah University, Universities Road, Madinah 42353, Saudi Arabia. ahasan@taibahu.edu.sa
Received: June 26, 2021
Peer-review started: June 26, 2021
First decision: July 14, 2021
Revised: July 16, 2021
Accepted: July 29, 2021
Article in press: July 29, 2021
Published online: November 16, 2021
Processing time: 136 Days and 12.5 Hours
Abstract
BACKGROUND

Abdominal lymphangiomatosis is a rare benign condition accounting for less than 1% of all the cases of lymphangiomatosis. Management usually involves radical surgical excision; however, depending upon the extent of involvement, patient condition, and absence of complications, conservative management can be also considered.

CASE SUMMARY

We present the case of a 32-year-old male who presented with short onset abdominal pain and melena. Physical examination findings were within normal limits, except for left lower abdominal tenderness. Upper gastrointestinal endoscopy was within normal limits. Abdominal and pelvic ultrasound and computed tomography (CT) scan revealed numerous, variably-sized cystic lesions within the abdominal cavity, exclusively and extensively affecting the small bowel mesentery with sparing of the retroperitoneum. The diagnosis was confirmed by CT and cytological examination. Radical surgical excision was technically impossible in this patient because of the extensive involvement of the mesentery; therefore, the patient was managed conservatively.

CONCLUSION

Extensive and exclusive small bowel mesentery involvement in abdominal lymphangiomatosis is rare. Imaging modalities play an important role in establishing the diagnosis and conservative management can be considered when surgery is technically impossible.

Keywords: Abdominal lymphangiomatosis; Mesentery; Melena; Computed tomography scan; Case report

Core Tip: Abdominal lymphangiomatosis is rare, accounting for less than 1% of all cases of lymphangiomatosis. The retroperitoneum is the typical site affected in abdominal lymphangiomatosis. Other than the retroperitoneum, the mesentery and omentum can also be affected. Here, we report a case of extensive mesenteric lymphangiomatosis without retroperitoneal involvement. Surgical excision was technically impossible in our case due to the extensive and exclusive involvement of the small bowel mesentery and the patient was managed conservatively.