In a rare Mesenteric cyst removal surgery, doctors from the Gynaecology and Surgical department at Paras Bliss Hospital, Panchkula, removed a 1.5 kilogram cyst while performing a caesarean delivery of 2.61 kilogram healthy baby girl. The team was led by Dr. Nupur Sharma, Consultant Gynaecologist and Dr. N. S. Sandhu, Consultant General and Paediatric Surgeon, Paras Bliss Hospital, Hospital.
Tara (name changed), a pregnant lady 26 years old came to the hospital complaining of acute abdominal pain. Investigations revealed the presence of a large cyst arising from her ovary. While the patient was aware about the cyst she forgot about it at the news of her conception and motherhood.
Mesenteric cyst is one the rarest abdominal tumours with approximately 1,000 cases reported out of which only 5 cases have been cured during pregnancy. The diagnosis and treatment of mesenteric cysts is challenging due to its rarity, lack of specific symptoms and variability in location and size. The cysts are diagnosed due to abdominal mass in 50% of cases and 40% may be discovered incidentally. 60% of the time they are usually found in small mesentery (a fold of tissue that attaches organs to the body wall) and 33% in the large bowel mesentery. Even though they are diagnosed by USG/MRI/CT, their site of origin remains unclear and they may be mistaken with ovarian cysts.
Dr. Nupur Sharma, Consultant Obstetrics and Gynaecologist, Paras Bliss Hospital, said, “The patient’s cyst was arising from the bowel and was thus missed in her routine pregnancy scans. Even at the time of her previous caesarean section, the cyst was not identified as her ovaries and tubes looked normal. When she conceived this time, the cyst increased enormously causing abdominal pain. When Tara came to us, we did extensive studies to detect the cause of her pain. Her USG scans indicated a large cyst from her ovary which needed immediate removal. Instead of performing a routine caesarean section from the lower part of her abdomen, we made vertical incision from umbilicus to symphysis. That gave us a better view of the cyst as well as made it possible to deliver her healthy fetus.”
Dr. N S Sandhu, Consultant General and Paediatric Surgeon, Paras Bliss Hospital, Panchkula, said, “Cases such as these are very rare, but it is important to diagnose such cysts pre-delivery so that they can be tackled with along with caesarean delivery. We were able to remove the cyst without having to put the patient under surgery again. Double surgeries put patient’s body under extreme stress and could in some cases lead to complications. Tara’s cyst was diagnosed well before her time of delivery, which gave us time to plan ahead. We successfully removed a 20×20 centimeters large mesenteric cyst weighing 1.5 kg along with her caesarean delivery. Both Tara and her baby girl are recovering well.”
The patient expressed her gratitude to the doctors, “I am very thankful to the team of doctors as it is only due to their expertise that i am a proud mother today.”
Mesenteric cysts are rare benign abdominal masses and the risk of them turning into cancer is <3%. The most common symptoms of this cyst are acute abdominal pain, vomiting, and distension of the abdomen. Clinical examinations reveal a mass in the abdomen in most cases. If the mass is easy to locate and reached, mesenteric cysts can be generally removed from the body. Early diagnosis and treatment yields excellent outcome. Women need to be cautious when it comes to pregnancy and cyst formations. Very often, cysts do not show up on regular scans during pregnancy. Informing your doctor about any complications such as ovarian or mesenteric cysts during pregnancy is vital. These cysts are easily amenable to removal at the time of caesarean delivery.
Doctors at Paras Bliss, Panchkula advocate that patients and doctors should work like a team for better care and outcomes.