Mesenteric cyst

　　Mesenteric cysts are congenital lymphatic spaces that gradually enlarge with the accumulation of lymph fluid. They can be caused by abnormal intestinal development during embryogenesis, or by mesenteric trauma leading to lymphatic stasis, or by parasitic infection.

　　1. Embryonic or developmental cysts This type of cyst is mostly caused by developmental abnormalities or congenital malformations.

　　2. Traumatic or acquired cysts may form after abdominal trauma or surgical trauma, if the mesenteric tissue bleeds, the hematoma becomes organized, or the lymphatic vessels rupture, causing lymph fluid to leak out and be encapsulated by fibrous tissue.

　　3. Tumorous or neoplastic cysts mainly include various benign and malignant cysts of the mesentery.

　　4. Infectious cysts The most common infectious cysts are tuberculous cysts, followed by fungal or parasitic cysts.

　　Complications of mesenteric cysts may include:

　　1. Intestinal obstruction Due to the weight of the tumor body, it is easy to cause torsion of the mesentery and intestinal tract, leading to acute intestinal obstruction; large cysts compressing the intestinal tract can cause chronic intestinal obstruction.

　　2. Urinary tract obstruction Large cysts compressing the ureter can cause symptomatic or asymptomatic urinary tract obstruction.

　　When mesenteric cysts occur, they may be accompanied by abdominal mass, abdominal distension, intermittent abdominal pain, decreased appetite, and other symptoms. Severe cases may be accompanied by fever, vomiting, and diarrhea, lasting for several days, and may recur after relief. Small cysts generally have no symptoms or signs. When the cysts grow to a certain size, a series of clinical symptoms and signs appear.

　　There is no pain or tenderness in the mesenteric cyst mass. When the cyst develops hemorrhage or infection, the mass may have tenderness. The boundary is clear or unclear, depending on the etiology, but there is no clear mass boundary. It has a cystic feeling or rubbery texture, and if the mass is too large, there is a water-tap feeling in the abdomen. The mobility is usually large and regular: since the root of the mesentery fixed to the posterior abdominal wall runs from left upper to right lower, it is longitudinally fixed, so the mobility of the mesenteric root cyst is large in the horizontal direction, along the right upper to left lower axis, while the vertical movement is limited; if the cyst is located around the mesentery, the range of movement in all directions is large.

　　Larger cysts can cause abdominal distension, and the patient's abdominal circumference gradually increases. Large cysts can be misdiagnosed as ascites, and small cysts can manifest as one-sided abdominal distension, and large cysts causing intestinal obstruction can also cause abdominal distension.

　　Abdominal pain is intermittent and recurrent. It is caused by the compression or torsion of the intestinal tract; larger cysts compress the mesentery, increasing its tension, which can also cause abdominal pain symptoms. Mesenteric cysts are located between the two layers of the mesentery, and when the patient moves, due to gravity, it may pull on the root of the mesentery or cause slight spasm of the intestinal tract, so abdominal pain is a common symptom. Mild abdominal pain can last for half an hour to several hours, and severe cases may be accompanied by fever, vomiting, diarrhea, lasting for several days, and may recur after relief. Other symptoms include: due to the mobility of mesenteric cysts, the weight of the tumor body is easy to cause intestinal torsion, and it often leads to acute intestinal obstruction. Mesenteric cyst obstruction. Large cysts can compress the intestinal tract, causing chronic intestinal obstruction, and a few significantly enlarged ones can produce local compression symptoms, such as compression of the gastrointestinal tract can cause intermittent abdominal pain, discomfort after eating, decreased appetite, nausea, and vomiting. Compression of the ureter can cause symptomatic or asymptomatic urinary tract obstruction. Some patients may develop ascites due to cyst rupture. Cyst erosion or invasion of the intestinal wall can cause hematochezia. Patients may also present with decreased appetite, weight loss, fever, nausea, vomiting, diarrhea, constipation, and other symptoms.

　　Mesenteric cyst (mesenteric cyst) refers to a cyst with an epithelial lining located in the mesentery. The vast majority are benign lesions, which are mostly due to congenital malformations or the development of ectopic lymphatic tissue, and also due to abdominal trauma, lymphatic inflammatory obstruction, or atrophic regression of localized lymph nodes. If mesenteric cysts are caused by pre-existing diseases (such as abdominal trauma or postoperative trauma, infectious tuberculous cysts, etc.), treatment of the primary disease can prevent the occurrence of mesenteric cysts.

　　1. X-ray examination: may not show positive findings, but can exclude urinary system or intestinal diseases. (1) Abdominal plain film: soft tissue shadows can be seen; when the wall of dermoid cyst or hydatid cyst is calcified, a ring-shaped calcification shadow can be displayed; dermoid cysts occasionally show teeth, bones, and other structures. (2) Barium meal or barium enema: intestinal compression and displacement can be seen: such as narrowing, elongation, and rigidity of the intestinal wall near the mass; difficulty or slow passage of barium; movement or arc-shaped indentation of the stomach, duodenum, and transverse colon. (3) CT scan: can provide the best cyst imaging diagnosis, can provide a definite location and nature, and is conducive to the differential diagnosis of mesenteric cysts.

　　2. Ultrasound examination: abdominal ultrasound can not only locate but also determine the nature. Due to its simplicity and non-invasiveness, it can be used for follow-up observation. For pseudocysts, it can serve as guidance for conservative therapy or surgical treatment. The ultrasound images of mesenteric cysts have the following characteristics: (1) Shape: circular or semicircular mass. (2) Boundary: due to the complete capsule, the cyst image has a clear, smooth, sharp, and can also be petal-shaped halo. (3) Internal reflection: local mesentery shows a liquid shadow. The number and distribution of echo spots within the liquid shadow vary due to the different properties and distribution of the cyst contents, such as if the cyst contents are mainly liquid or mainly formed by uniform coagulation of desquamated material, then due to fewer reflection interfaces, the ultrasound image shows very few or no internal echo; if the desquamated material is scattered and suspended in the liquid, there will be more echo spots or spots, and the distribution is uneven. (4) Sound penetration: sound penetration varies with the amount of liquid content. For those with more liquid content, the posterior wall reflection is stronger, and the sound penetration is good; otherwise, it is moderate or poor. (5) Compressibility: has obvious compressibility.

　　3. Laparoscopic examination: can directly observe the location and size of the cyst.

　　Mesenteric cysts are mostly benign, such as intestinal cysts, colonic mesenteric serous cysts, dermoid cysts, and so on. Initially, there are no obvious symptoms. When the tumor grows larger, or the cyst develops intracystic hemorrhage or secondary infection, there may be dull or bloating pain, and the patient may be able to feel an abdominal mass.

　　It is recommended to 

　　(1) It is recommended to consume more foods that can shrink tumors: jellyfish, oyster, sea horse, crab, white snake, clam, skate, kiwi fruit, fig, walnut, hawthorn, papaya, plum, sugarcane, almond, lotus seed, silver ear, melon, luffa, mushroom, and broad bean.

　　(2) For abdominal pain, eat horseshoe crabs, sharks, celery, pumpkin, chives, hawthorn, tangerine candy, soy sauce, loofah.

　　(3) For edema and decreased urine, eat scallions, chrysanthemum buds, snails, earthworms, almonds, crabs, kelp, clams, kombu, sturgeon, red beans, crucian carp, lettuce, coconut milk, and tilapia.

　　(4) For irregular bowel movements, eat figs, wheat bran, hawthorn, shark, mackerel, rabbit meat.

　　Avoid 

　　(1) Avoid smoking, alcohol, and spicy刺激性 foods.

　　(2) Avoid moldy, contaminated, hard, rough, fibrous, greasy, sticky, indigestible foods.

　　(3) Avoid fried, smoked, pickled, raw and mixed foods.

　　(4) Avoid gas-forming foods such as soybeans, green beans, and sweet potatoes.

　　(5) Avoid overeating and forcing food down.

　　The Western medical treatment for mesenteric cysts is surgery.

　　1. Cyst Excision is the most ideal surgical method, and it should be performed as much as possible without affecting the blood supply of the intestinal tract.

　　2. Cyst and Intestinal Resection with End-to-End Anastomosis Since most mesenteric cysts are very close to the intestinal tract, it is often impossible to excise them alone, and it is necessary to resect the cyst and the connected intestinal tract together, and then perform end-to-end anastomosis of the intestinal tract. It is especially necessary to resect the whole piece when the cyst causes intestinal obstruction or necrosis.

　　3. Cyst-enteric Anastomosis or Pouch Suture If the cyst is large or because the cyst is located at the root of the mesentery, there is a possibility of injury to large blood vessels during resection, then cyst-enteric anastomosis or pouch suture can be considered. However, due to the risks of recurrence, infection, and malignancy, it is generally not advisable to use this method.

　　4. Partial Cystectomy When the cyst is widely distributed or there are multiple cysts, if a complete cystectomy is performed, it may cause blood supply obstruction of a large segment of the intestinal tract. In this case, partial cystectomy can be performed, leaving the remaining part of the cyst wall completely exposed in the abdominal cavity, or 3% iodine tincture can be used to wipe the residual cyst membrane to reduce its secretion. Some people have found that the secretions of the residual cyst membrane can be completely absorbed through the peritoneum to achieve a balance between absorption and secretion.

　　5. Laparoscopic Surgery Laparoscopic surgery for certain abdominal diseases is a new technology that has developed in recent years, with many advantages such as minimal injury and fast healing. It can be used to remove cysts. For refractory ascites caused by lymphangiomatosis, there are reports that when lymphangiography is used to make an accurate diagnosis, iodinated oil is injected to obtain a cure by embolizing the lymphatic vessels.