Abdominal lymphangiomas in children

Abdominal lymnphangiomas are relatively uncommon abdominal tumors of childhood, and may vary in presentations from an asymptomatic mass to acute abdomen. Seven children (3 boys, 4 girls), aged from 2 months to 11 years old (mean 6.4 years), with abdominal lymphangiomas have been confirmed over the past 6 years at this institution. Of these, six were symptomatic, with abdominal pain (six), vomiting (five) and abdominal distension (three) predominating. Duration of the symptoms in the majority of cases was less than one week. Three children presented with acute abdomen, initially diagnosed as complete small bowel obstruction, acute appendicitis or torsion of ovarian cyst, respectively. One lymphangioma case was complicated by small bowel volvulus, but no intestinal gangrene was found during laparotomy. Although multiple imaging modalities were used, ultrasound (US, 3/5) and computer tomography (CT, 3/3) proved most expedient and reliable. Of the five lymphangiomas located within the mesentery, two were at the root of the mesentery with retroperitoneal extension. Four children needed bowel resection to remove the lymphangioma completely. One retroperitoneal lymphangioma could not be completely resected, but no recurrence was detected later. All patients recovered uneventfully after surgery. US and CT detected the infrequent abdominal lesions in most cases. It is suggested that US should be used liberally on children with ambiguous abdominal complaints, and can lead to prompt recognition and definitive treatment. Early diagnosis, while the abdominal lymphangioma is still small facilitates early excision. This is recommended to prevent catastrophic complications.