Chylolymphatic Cysts in Children: A Rare Condition

Abstract

Objective: To find out the clinical findings, anatomical types and preferred operative treatment for paediatric chylolymphatic cysts. Study Design: Prospective study Place and Duration of Study: Department of Pediatric Surgery/General Surgery Bahawal Victoria Hospital, Bahawalpur and Department of Pediatric Surgery/General Surgery Unit-ll, DHQ Teaching Hospital, Dera Ghazi Khan from 1st January 2018 to 31st December 2020 Methodology: Fifteen patients of either gender with age from 18 months to 8 years (96 months) enrolled. Clinical data of all the patients diagnosed as chylolymphatic cyst on exploration was recorded. Results: There were 8 (53.3%) females and 7 (46.7%) males with mean age was 49.80±27.07 (months). Four patients (26.66%) presented with abdominal mass, 5 patients (33.33%) presented with abdominal pain, 1 patient (6.66%) with abdominal mass and pain while 5 patients (33.33%) presented with signs of intestinal obstruction. Three (20%) had cysts at multiple sites, i.e., mesentery of jejunum, ileum and mesentery of sigmoid colon, 5 (33.33%) patients had cysts in jejunal mesentery while 9 (53.33%) patients’ cyst was found in ileal mesentery and 1 (6.66%) had cyst in mesentery of cecum. Fourteen underwent exploratory laparotomy and 1 was managed laparoscopically. Post-operative recovery in 14 patients was uneventful and 1 patient managed by open surgery underwent respiratory complications and later expired. No recurrence was noted during follow up period up to 6 months. Conclusion: Surgical exploration and surgical excision and sometimes resection anastomosis of gut is mainstay of treatment with excellent results. Key words: Paediatric mass abdomen, Mesenteric cysts, Chylolymphatic cyst, Paediatric surgery