Ref Number = PITIKA-ASPR0390
M. Farid Huzein, Eka Yusuf Inra, Setia Budi Salekede
Objective. Mesenteric cyst is a rare intra-abdominal tumor found mostly in childhood around one case per 200.000 hospital admissions. Clinical manifestation varies ranging from an asymptomatic mass to acute abdomen and frequently detected during routine abdominal workouts or in laparotomy intervention. Radiological examinations of choice for diagnosis are ultrasonography and CT-scan. The goal therapy is surgery with complete excision of the mass. We report a case of intestinal obstruction due to mesenteric cyst in a 1-month 11 days-old girl.

Case. A 1-month 11 days-old girl was admitted due to abdominal distention10 days before admission. She has had non projectile vomiting and defecate less in quantity with runny consistency. Fever was noted since 5 days before admission and neither history of meconium delay or early solid feeding. Physical examination revealed an abdominal distention with increased bowel movement. After 5th days of intervention using rectal tube, the abdominal distention decreased in size and palpable mass appeared in right hypocondrium region. Abdominal CT Scan revealed a hypo dense mass 6x9 cm, firm boundary, regular edge, non calcification on the mesentery. Laboratory examination revealed anemia (Hemoglobin level 6,5 gr/dl) and leukocytosis (WBC count 11.200/mm3) with “shift to the left” (percentage of neutrophil 82%). She was treated with antibiotic and complete excision of the mass with laparatomy procedure. Histopathological examination showed fibrous connective tissue with spindle core and many neutrophil cells, suitable for mesenteric abscess.

Conclusion. A case of intestinal obstruction due to mesenteric cyst in a 1-month 11 days-old girl was reported. The diagnosis was based on history taking, physical examination, laboratory, and radiological finding. Complete excision of the mass with laparatomy procedure was the choice of intervention for the case.  The prognosis  was dubia ad bonam.
Keywords: mesenteric cyst, intestinal obstruction, 1-month-old baby
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