Mesenteric cystic lymphangioma: unusual cause of intra-abdominal catastrophe in an adult

Mesenteric cystic lymphangiomas (MCLs) are rare benign cystic tumours of unknown aetiology, most often seen in paediatric patients. The clinical presentation is diverse, ranging from an incidentally discovered abdominal cyst to symptoms of acute abdomen. A 20-year-old male presented with generalised abdominal pain, nausea and vomiting of several hours duration following heavy lifting. Emergency laparotomy revealed a 15 x 10 x 8-cm pedicled cystic mass of the mid-ileal mesentery, causing a volvulus. The cyst and a 20-cm gangrenous intestinal segment were resected with anastomosis. The postoperative course was uncomplicated. MCLs should be included in the differential diagnosis of cystic intra-abdominal lesions. Even when asymptomatic and discovered incidentally, they must be treated surgically because of the potential to grow, invade vital structures and develop life-threatening complications.