Laparoscopic Excision of a Simple Mesenteric Cyst of the Caecal Mesentery – A Rare Case Report

Abstract

Mesenteric cysts are rare benign abdominal lesions that can occur anywhere from the duodenum to the rectum, with an incidence of approximately 1 in 100,000 to 1 in 250,000 patients. They are often benign and asymptomatic but may present with symptoms such as abdominal pain, nausea, vomiting, or intestinal obstruction due to volvulus. The treatment of choice is complete surgical excision, preferably by laparoscopy. Simple aspiration or drainage is not recommended because of the high recurrence rate. Laparoscopic resection offers advantages such as minimal pain, shorter hospital stays, and faster recovery. In this report, the case of a 45-year-old male with a simple mesenteric cyst located in the caecal mesentery, positioned inferior to the cecum and near the ileocecal junction, is presented, which was successfully treated with laparoscopic excision. Laparoscopic exploration revealed a thin-walled cystic structure containing clear yellowish fluid, situated inferior to the cecum, with the appendix lying medial to the cyst. A concomitant laparoscopic appendectomy was performed. Histopathological examination revealed a benign simple mesenteric cyst with a fibrocollagenous wall lined by cuboidal to flattened mesothelial cells. It was concluded that in recent years, laparoscopic complete excision has become the preferred approach due to its advantages, including reduced postoperative pain, faster recovery, and shorter hospital stay. Complete surgical removal of the mesenteric cyst remains the key to achieving an optimal outcome and preventing recurrence.