Inadvertent Tattooing of Adjacent Large Bowel: a Case Report and Review of Literature

There are no pathognomonic signs and symptoms of mesenteric cyst; However, paper presented by Santana et al. 11 reporting 18 cases showed abdominal pain and mass (72%), vomiting and constipation; one patient presented with acute abdomen pain. Palpation usually presents itself painless, smooth contour and well defined with mobility in the transverse direction and around its axis (Tillaux signal) 2-11 The increase in abdominal volume is slow, progressive and late noticed in some cases, mingling with ascites in about 18-20%. There are few reports of malignant mesenteric cysts, usually low-grade sarcomas. Kurtz et al. reviewed 162 cases and found only 3% of malignant transformation, all in adults. Are incidental findings during laparotomy or imaging, up to 40 % of cases. Acute abdomen occurs when there is rupture, infection, bleeding or twisting of the cyst, and confused with appendicitis or aortic aneurysm. Laboratory tests little help the diagnosis. Simple X-rays of the abdomen may show calcifications; arteriography and intestinal transit may show compressive mass. However, ultrasonography, computed tomography computed and magnetic resonance imaging are the exams that provide better diagnosis. Once diagnosed, all mesenteric cyst should be resected in order to avoid their complications 2-11 , recurrence, malignant transformation and possible complications (hemorrhage, torsion, obstruction, traumatic rupture and infection) 8-12. Internal drainage may be an option when there is possibility of short bowel syndrome. In selected cases laparoscopic approach can be used 13-15. Santana et al. 11 classified them as pathologically serous, bloodserous, chylous, with blood. In this case hydatid cist was also placed on judgment in the differential diagnosis, before the end of lymphangioma. REFERENCES 1. Alvarez C et all.Linfangioma cístico do pâncreas. Revista do Colégio Brasileiro de Cirurgiões: Vol. 27 – 6-n.430.