Mesenteric and omental cysts are rare intra-abdominal lesions. The rar
ity of these lesions, with an incidence of only about 1 in 140,000 hos
pital admissions, and the absence of characteristic clinical findings
makes diagnosis difficult. Fourteen patients were treated for either m
esenteric and/or omental cysts between 1965 and 1994 at Egleston Child
ren's Hospital at Emery University. Of the 14 patients, 6 were female,
8 male; 3 were non-Caucasian, and 11 were Caucasian. They ranged in a
ge from in-utero to 12 years old, with the most common presenting symp
toms being abdominal distention (71%), pain (50%), vomiting (50%), and
pain and distention (43%). Ultrasonography was the diagnostic method
of choice. Other diagnostic modalities included intravenous pyelogram,
barium enema, upper gastrointestinal series, CT scan, and MRI in sele
cted patients. A single mesenteric cyst (79%) was most common, with on
ly one patient (7%) having multiple mesenteric cysts as well as an ome
ntal cyst. The remaining two patients (14%) had single omental cysts.
On gross examination, most (64%) were single, multilocular cysts. On p
athological examination, the cysts ranged in size from 3.5 x 1 x 0.2 c
m to 30 x 40 x 10 cm, with a mean of 14.9 x 11.5 x 4.7 cm. Six of the
14 contained fluid consistent with hemorrhage into the cysts. The most
common treatment was simple excision (71%) followed by excision with
partial bowel resection (29%). None received drainage alone as a treat
ment. There were no major postoperative complications and no reported
recurrences of the cysts.