Giant Mesenteric Cyst of The Large Bowel: Case Report

Introduction: Mesenteric cysts are rare, benign intra-abdominal cystic lesions that arise from the mesentery, the tissue fold attaching the intestines to the abdominal wall. They can develop from the duodenum to the rectum. Mesenteric cysts have various histological origins, with lymphangiomas being more common in children and mesothelial cysts in young to middle-aged women. While they can remain asymptomatic, they may also cause complications such as intestinal obstruction or perforation. Complete resection is the preferred treatment due to its lower recurrence rate. Case Presentation: A 48-year-old female with a medical history of systemic arterial hypertension, allergies, hysterectomy, appendectomy, cesarean section, right axillary lipoma resection, and a cyst in the left zygomatic region, presented in June 2021 with dull, constant pelvic pain. Over time, her symptoms progressed to include volume increase, fatigue upon sitting, constipation, and hand tremors. Imaging studies revealed a large cystic lesion extending from the left ovary. In January 2024, an abdominal ultrasound showed a complex ovarian cyst (O-RADS 4). Surgical exploration revealed a mesenteric cyst associated with the sigmoid colon, which was resected along with a distal segment of the descending and sigmoid colon, preserving the left colic artery. The patient recovered well postoperatively, with proper colostomy function. Discussion: Mesenteric cysts are benign tumors that can occur throughout the gastrointestinal tract, most commonly in the small bowel mesentery. Their clinical presentation can range from asymptomatic to acute abdominal pain secondary to complications such as intestinal obstruction or cyst rupture. Diagnostic imaging typically involves ultrasound, CT, and MRI. Surgical resection is the treatment of choice to prevent recurrence. The prognosis following complete cyst excision is favorable, with no reported recurrences. Conclusion: Mesenteric cysts present a diagnostic challenge due to their wide range of symptoms. The recommended treatment, as supported by literature, is complete resection to minimize recurrence. Our case followed this approach, and the patient showed a positive clinical outcome