2020 Volume 56 Issue 7 Pages 1150-1155
Mesenteric lipomas are relatively rare, benign tumors in children. We present a case of mesenteric lipoma in a child with symptoms of partial bowel obstruction, diagnosed preoperatively via abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). A 7-year-old boy with a history of recurrent abdominal pain and failure to thrive presented with symptoms of vomiting over the last four days. Physical examination revealed slight abdominal distention without a palpable mass. Plain abdominal radiography revealed small bowel loop distention, with a flat, dilated junction segment, indicating mechanical intestinal obstruction. Ultrasonography revealed a heterogenous echogenic mass lesion within the pelvic cavity. CT revealed a well-encapsulated nonenhancing mass with nodular organization and negative attenuation values. T1- and T2-weighted MRI sequences revealed that the mass showed hypersignal intensities and was mobile, which are indicative of mesenteric lipoma. Laparotomy revealed a smooth, round, soft, yellow mass measuring approximately 8.5×8.0×3.0 cm, arising from the mesentery, 80 cm proximal to the ileocecal valve. Resection of the affected segment of the ileum and end-to-end ileal anastomosis were performed. Histopathological analysis showed that the tumor was composed of mature adipocytes without atypia, confirming the diagnosis of mesenteric lipoma. The findings were negative for malignancy. No recurrence was observed during the two-year postoperative follow-up. The clinical presentation of the case was indicative of partial obstruction due to compression with spontaneous detorsion. Mesenteric lipoma should be considered a possible differential diagnosis in children with recurrent abdominal pain and failure to thrive.
