A giant omental cyst mimicking ascites in a three-year-old Congolese child

Introduction: Omental and mesenteric cysts are rare intra-abdominal lesions. They can present as an abdominal distension and make differential diagnosis with ascites. Case Report: A three-year-old boy with fever, under nutrition and abdominal distension previously diagnosed as ascites was submitted to laparotomy. We founded a large multi lobed cyst from the large omentum filling almost the entire abdominal cavity and containing sero-hemorrhagic to very dark liquid. The histopathologic examination showed a cystic formation lined by cubic mesothelium cells, with abundant inflammatory infiltrate rich in lymphocytes and histiocytes, mixed with a few giant cells of foreign body of melanotic origin. Conclusion: The diagnostic role of sonography in abdominal distension of unknown etiology is emphasized.