Abstract
Ovarian torsion causes acute abdomen, and it is increasingly being treated with laparoscopic surgery, even in emergencies. Herein, we report a case of a 27-year-old woman who underwent laparoscopic surgery for excision of mesenteric lymphangioma, which could not be easily differentiated from ovarian torsion. Three days before her visit to our department, she visited her former physician because of lower abdominal pain and was diagnosed with an ovarian cyst. She then visited our department because of worsening lower abdominal pain. Ultrasonography showed a multilocular cystic tumor (9 cm in diameter), and tenderness was noted over the pelvis. Therefore, ovarian torsion was suspected, and emergency laparoscopic surgery was performed. We detected a smooth surface tumor in the pelvis; the tumor originated from the sigmoid colon mesentery. No abnormal findings were observed in the uterus and bilateral adnexa. The tumor was excised; multilocular cysts were recognized on the cut surface of the excised specimen, and serous fluid in the cyst was observed. A diagnosis of mesenteric lymphangioma was made via histopathological examination.
Lymphangiomas commonly develop in the neck and armpits in children and rarely develop in the mesentery in adults. Although laparotomy was previously the treatment of choice for these tumors, laparoscopic surgery is being increasingly used for treatment in recent years. It is important to differentiate mesenteric lymphangiomas from ovarian cysts, and concurrent use of computed tomography (CT), magnetic resonance imaging (MRI), and other imaging modalities can help increase the rate of diagnosis. However, lymphangiomas are sometimes only detected during surgery, and it is important to work closely with other hospital departments in such cases.
