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Arch Surg. 2005;140:706.

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Answer: Cystic Lymphangioma

Intra-abdominal cystic lymphangiomas are extremely rare entities whose origins are related to congenital defects of the lymphatics. Lymphangiomas generally occur in children, who remain asymptomatic until early adulthood. Lesions may be discovered incidentally or progress to produce vague and chronic abdominal symptoms, possibly secondary to a mass effect.¹ Lymphangiomas do not generally regress. As such, surgical intervention is preferred and, with complete resection, offers an excellent prognosis. Two independent studies reported recurrences in 10% of patients in whom primary resection was incomplete.^1-2 Chylous ascites may occur if the stem of the cyst and feeding lymphatics are unsuccessfully ligated.³ Management of this condition may include the placement of drains as they facilitate the injection of fibrinogen and thrombin, especially when drainage is persistent.⁴

Depending on the size and location of the mass, laparoscopic resection has been proposed as a potentially safe and minimally invasive means of surgical management.^5-6 However, complete resection . . . [Full Text of this Article]

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Arch Surg. 2005;140(7):705.
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