Successful laparoscopic removal of mesenteric and omental cysts in toddlers: 3 cases with a literature review Arzu Pampal a, ⁎ , Aydin Yagmurlu b a Ufuk University, Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey b Ankara University, Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey Received 11 January 2012; revised 24 March 2012; accepted 25 March 2012 Key words: Mesenteric cyst; Omental cyst; Laparoscopy; Minimally invasive surgery; Children Abstract Mesenteric and omental cysts are rare benign intraabdominal anomalies with uncertain etiologies. Surgical removal is the preferred treatment owing to complications related to cyst enlargement. A 1-year-old boy with an intrauterine diagnosis of a cystic mass adjacent to his stomach and liver, a 3-year-old girl, and a 3-year-old boy with an incidental diagnosis of intraabdominal cysts were scheduled for laparoscopic surgery. The mass of the 1-year-old boy was a multiloculated cyst originating from the lesser omentum, the incidental mass in the girl was a multiseptated cyst located in the jejunoileal mesentery, and the incidental mass of the 3- year-old boy was a uniloculated cyst originating from the ileal mesentery. All the cysts were excised either laparoscopically or in a laparoscopy-assisted manner. The laparoscopic or laparoscopy-assisted excision of the mesenteric and omental cysts seems to be a feasible, safe, and cost-effective surgical procedure with shorter operative times, even in toddlers. © 2012 Elsevier Inc. All rights reserved. Mesenteric and omental cysts are uncommon intraabdom- inal masses, generally of a benign nature. The incidence of mesenteric cysts is nearly 1 of 105,000 hospital admissions, and the incidence of omental cysts is even more rare. These cysts are more common in the adults, with only 25% of cases diagnosed before the age of 10 years [1]. Despite the recent literature setting cystic intraabdominal lymphatic malforma- tions apart from the mesenteric and omental cysts with regard to their pathologic findings and clinical behavior, all omental, mesenteric, and retroperitoneal cysts are actually the exten- sions of what were originally retroperitoneal anlage during embryogenesis and complete excision of the intraabdominal cysts of any nature is the treatment of choice. Despite the earlier findings of limited intraabdominal working space for laparoscopic procedures in infants and young children leading to more difficult and time-consuming operations, with time and operator experience, minimally invasive surgery in pediatric-aged individuals has become more widely used. This report describes 3 toddlers with intraabdominal mesenteric or omental cysts successfully excised laparoscopically or with laparoscopy-assisted opera- tions and reviews the pediatric cases treated by minimally invasive surgery in the literature. 1. Case reports 1.1. Case 1 A 13-month-old boy with an intraabdominal cystic mass that had been discovered at the 36th week of gestation was scheduled for a laparoscopic excision. The boy was a term baby with no signs or symptoms of gastrointestinal obstruction. The prenatal ultrasound revealed a 2-cm cystic ⁎ Corresponding author. Tel.: +90 312 2044269; fax: +90 312 2026213. E-mail address: ademirtola@yahoo.com (A. Pampal). www.elsevier.com/locate/jpedsurg 0022-3468/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.jpedsurg.2012.03.080 Journal of Pediatric Surgery (2012) 47, E5–E8