PMC9633568_01
Abdominal X-ray. Displaced bowel loop into the left upper quadrant (white arrow), no abnormal calcification, free air, or pneumatosis.
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However, abdominal radiograph demonstrated abdominal mass-effect displacing the bowel loops into left upper quadrant, distended loops with multiple air-fluid level Fig. 1.
Abdominal ultrasound. (A, B) Dilated owl segments at midline and LUQ (white arrows). (C) Large cystic lesion occupying the pelvis with separation and floating debris (green arrow). (D) Left kidney with dilated renal pelvis (red arrow); hydronephrosis were noted bilaterally.
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Corresponding ultrasound presented dilated bowel and ascites with floating debris, there were stable bilateral hydronephrosis Fig. 2.
CECT. Bowel loop are localized into the LUQ, with patent vessels (red circles). The cystic lesion occupying the whole abdomen with homogenous contents (red arrows). There were no sold component, abnormal abdominal calcification, pneumatosis, or free air.
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The impression was strangulated lesser sac, internal hernia with large ascites and no bowel ischemia Fig. 3.
(A) Gross specimen. (B) Image from hematoxylin and eosin (H&E) stained slide shows small intestine (green arrow) with mesenteric cystic lymphangioma. (C) There are variable sized lymphatic cysts lined by a single layer of endothelial cells (black arrows).
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The lesion consists of 2 intact separated cysts attached to the mesentery of a segment of small intestine (Fig. 4A).