Laparoscopic Enucleation of Mesenteric Cyst: A Case Report DURSUN ALı SAHıN, M.D. 1 , GOKHAN AKBULUT, M.D. 1 , VOLKAN SAYKOL, M.D. 1 , OSMAN SAN, M.D. 1 , CıGDEM TOKYOL, M.D. 2 , AND OSMAN NURı DıLEK, M.D. 1 Abstract Intra-abdominal lesions, such as mesenteric cysts, are uncommon disorders. Most are discovered inci- dentally during routine abdominal examinations. They generally do not show typical clinical findings. Laparoscopic surgery has been used to remove a wide variety of mesenteric cysts. We report a patient with a mesenteric cyst, who was treated by laparoscopic enucleation. Key Words: Mesenteric cyst, laparoscopic enucleation. Introduction MESENTERIC CYSTS are rarely seen intra-abdminal lesions. The average incidence of these lesions is approximately 1:100,000 in adults, 1:20,000 in children (1, 2). They can be uni- or multilocular, and are mostly benign. Approximately 830 cases have been reported in the literature and only four of them were found to be malignant (1 – 5). Although mesenteric cysts are usually diagnosed during routine abdominal examinations, they can present with various signs, such as acute abdominal pain, chronic abdominal pain, nausea and vomiting, or change in bowel habit. Although rare, shock due to rupture or bleeding of the cyst, intestinal obstruction secondary to external compression and volvulus or torsion of the cyst have been reported (1 – 3). Case Report A 74-year-old woman was admitted to our de- partment with non-localized abdominal pain and constipation during the previous year. Physical ex- amination did not show any abnormality other than a median incision scar on the lower abdomen from a hysterectomy which she had had for myoma 15 years ago. All laboratory tests, including malig- nancy parameters, were within normal limits. Abdominal ultrasonography showed a cyst 5 cm in diameter at the mesentery of the ileum on the right lower quadrant. The nature of the cyst was homogeneous with low internal echo. Computed tomography (CT) showed the cyst to be circum- scribed and unilocular with a thin capsule, located at the mesenterium of the ileum (Figure). Three trocars were used: a 10 mm trocar was placed at the midline, 2 cm above the umblicus, using an open technique; a 5 mm trocar was placed lateral to the left rectus abdominus muscle at the left upper quadrant; and a second 5 mm trocar was placed lateral to the left rectus abdominus muscle © THE MOUNT SINAI JOURNAL OF MEDICINE Vol. 73 No. 7 November 2006 1019 Departments of 1 General Surgery and 2 Pathology, School of Med- icine, Afyon Kocatepe University, Afyonkarahisar, Turkey. Address all correspondence to Dursun Ali Sahin, M.D., Asst. Prof. of General Surgery, Ali Cetinkaya Kampusu (Mavi hastane), 03100 Afyonkarahisar, Turkey; e-mail: dursunalisahin@yahoo.com and dsahin@hotmail.com Accepted for publication March 2006. Figure. Abdominal computed tomography shows a unilocular (arrow), well-circumscribed cyst with a thin capsule, located in the mesenterium of the ileum.