Chylolymphatic cyst as a rare cause of acute intestinal obstruction in infants

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Abstract

Background
Chylolymphatic cysts are benign pathology in lymphatic vessels due to obstruction in the lymphatic system. Their incidence is still unknown. However, they account for approximately 3 to 9% of all pediatric lymphangiomas. Most of these lesions are asymptomatic and are discovered accidentally. They can be presented with nonspecific abdominal pain, vomiting, and changes in bowel habits. Rarely, chylolymphatic cysts can as intestinal obstruction, volvulus or even torsion.
Case presentation
A 3-month-old male presented to our unit with manifestations of acute intestinal obstruction. Abdominal examination revealed signs of generalized peritonitis and intestinal obstruction. Abdominal ultrasound revealed minimal turbid intraperitoneal collections and no motility of bowel loops. Plain erect abdominal radiograph revealed multiple small bowel air fluid levels. Abdominal exploration revealed a large chylolymphatic cyst causing acute intestinal obstruction. Excision of the cysts was done with preservation of adjacent bowel loop. The patient was discharged in good health on the 6th day postoperative. A chylolymphatic cyst with a diameter of 5 cm was identified by histological investigation.
Conclusions
Most chylolymphatic cysts in infants are asymptomatic, but they can cause fatal complications such as intestinal obstruction, volvulus, or even torsion.

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