Mesentery lymphangioma led to the acute abdomen, a case report with a rare location and unexpected diagnosis.

INTRODUCTION: Lymphangioma is a benign tumor, containing thin-walled lymphatic spaces. The most affected sites are head, neck, axilla, and parenchymal organs. Mesentery lymphangioma is a rare case; it happens in <1 % of cases.

PRESENTATION OF CASE: A 25-year-old man came to the hospital, complaining of acute abdominal pain. The pain started in the morning and developed progressively. The physical examination was not helpful. The abdominal X-ray in the erect position was within normal. The ultrasound imaging findings were limited; they showed only a cystic mass in the pelvis. So, the investigatory laparotomy was indicated. During the laparotomy, we found a sizeable mass originating from the small bowel mesentery and pressed on it. The mass is located at a distance of 50 cm from the treitz ligament. We excised the mass and related intestinal loops. The histopathological examination showed that it was a cystic lymphangioma.

DISCUSSION: Lymphangioma is a benign tumor that forms when early lymphatic spaces fail to connect to the lymphatic system. The diagnosis of the lesion depends on radiological investigations because the manifestations and the laboratory investigations are not specific, but histopathology examination is still the only method to determine diagnosis. The treatment of lymphangioma depends on radical surgery.

CONCLUSION: Mesenteric lymphangioma is a rare condition with unspecific symptoms and radiological and laboratory findings, so we should keep it in mind when the patient comes with general abdominal manifestations and we cannot put a determined diagnosis. Laparotomy should be done rapidly in such cases to avoid life-threatening complications.