LAPAROSCOPIC EXCISION OF A CYSTIC LYMPHANGIOMA

A 16-year-old female was evaluated for recurrent episodes of acute abd ominal pain and distension. Initial abdominal radiographs were consist ent with recurrent gastric volvulus. Following nasogastric tube decomp ression, reexamination revealed a mobile abdominal mass in the left up per quadrant. Contrast studies followed by computed tomography demonst rated a cyst measuring 9x7x6 cm with no obvious relationship to abdomi nal viscera. Laparoscopy was performed with a 10-mm port at the umbili cus and right upper quadrant, and a 5-mm port in the left lower quadra nt. The cyst was excised from the mesentery of the proximal jejunum an d placed in a laparoscopic sac. Controlled incision and drainage of th e cyst within the sac facilitated its removal from the abdomen with ne ither enlargement of the trocar site nor intraabdominal spillage. To p revent recurrent gastric volvulus, a gastropexy was performed from the greater and lesser curvatures to the anterior abdominal wall. The his tology was typical of a cystic lymphangioma, The patient was discharge d on the third postoperative day without complication. Laparoscopic te chnique allowed the performance of both procedures without large incis ions. This is the first reported laparoscopic excision of a cystic lym phangioma.