Laparoscopic Resection of a Large Omental Cyst: A Case Report

Abstract

Objective: Mesenteric and omental cyst are the rare intra-abdominal pathologies. We report laparoscopic excision of a large omental cyst in an adult patient.
Methods: A 56 year-old female presented with a year history of upper abdominal pain with palpable mass at epigastrium. On physical examination, a non-tenderness mass, 8 cm in diameter, was noted in the right upper abdomen. Abdominal CT revealed large thin wall cyst without solid nodule or septation at right upper abdomen. Endoscopic ultrasonography revealed no demonstration of its origin without connection to duodenal wall, pancreatic and bile duct. The patient underwent a complete excision by laparoscopic approach. Intraoperative finding revealed an encapsulated thin wall smooth surface cystic mass in lesser sac. The patient made an uneventful postoperative recovery. Pathological examination showed simple mesothelial cyst.
Discussion: Omental cysts often tends to be asymptomatic and is identified incidentally on imaging studies or at laparotomy. Ultrasonography, computed tomography and magnetic resonance imaging is a useful investigation to a correct diagnosis in patients with large cystic mass. Endoscopic ultrasonography is useful in distinguishing lesions arising in the wall of the GI tract from lesions. The complete excision is the treatment of choice. The advantages of laparoscopic approaches compared with open surgery are less postoperative pain, earlier recovery, shorter hospital stay, and better cosmetic. However, minimally invasive techniques should not compromise the basic surgical principles of complete excision.
Conclusion: In our patient, we confirm the feasibility and safety of laparoscopic resection in large omental cyst.