Omental cyst: a case report and review of the literature

Background Omental cysts are rare, predominantly occur in children, and often initially present with symptoms masquerading as other more common intra-abdominal pathologies. In this case report, we present the case of a child with an omental cyst that originated from the lesser sac. Due to the location of this cyst, resection presented unique technical challenges that have not been described in existing literature. Case presentation A 4-year-old male patient presented with symptoms initially concerning for appendicitis. Ultrasound showed a normal appendix but a large volume of complex intraperitoneal fluid. Computed tomography subsequently demonstrated a large cystic structure spanning from the stomach to the bladder. The patient was taken to the operating room where a large omental cyst was found to originate from the lesser sac. The resection was difficult due to the thin wall of the cyst and the intimate association of the superior-most aspect of the cyst with the tail of the pancreas, but was ultimately successful. Conclusions Omental cysts are rarely suspected before detection on abdominal imaging. Surgical resection is the treatment of choice, and complete resection can result in a recurrence-free postoperative course. Laparoscopic resection has been reported, but laparotomy is reasonable when a minimally invasive approach may not allow for a safe resection without rupture of the cyst. Anatomical characteristics of the cyst, as demonstrated in our case, can present challenges in the treatment of this otherwise benign entity.

Laparoscopic excision of large omental cyst at department of pediatric surgery in Sanglah general hospital, Bali, Indonesia

Omental cyst is rare. All conditions most likely being of congenital or benign neoplastic lymphatic origin. Patients with Omental cysts usually present with abdominal distention and a painless abdominal mass. The most common physical finding of an omental cyst is a freely movable abdominal mass. The diagnostic procedure include CT scans. Complete excision by open or laparoscopically of the cysts is considered as the treatment of choice. Recurrence and malignant deterioration of omental cysts are rare. A case report of a large omental cyst which had been laparoscopically-treated using morcellator. Laparoscopic morcellation is a technique used in gynecological surgeries such as hysterectomy and myomectomy to remove uteri and uterine fibroids (leiomyomas) through a small abdominal incision. Authors present a case of 3 year old female with pre-operative assessment tumor intra-abdominal suspect abdominal cyst. Subsequently, laparoscopic resection of omental cyst with morcellator was performed. The histopathological report was omental cyst. Omental cysts are rare, but can be shown to have atypical abdominal symptoms and radiologic findings, so clinicians must keep in mind that omental cysts causing abdominal symptoms can be misdiagnosed as simple ovarian cysts of inflammation. Omental cysts can be removed safety laparoscopically with morcellator without bowel or vessel injury.