Obstructive mesenteric cyst is not always the cause of obstruction

Background: In newborns presenting with clinical signs of obstruction of the small bowel, atresia of the small bowel as well as mesenteric cyst can be one of the differential diagnoses. Whereas clinically these two different diagnoses cannot be distinguished from each other, the operative therapy is different. Mesenteric cysts should, if possible, be enucleated, whereas small bowel atresias should be resected and anastomosed.

Methods (case report): We describe the case of a newborn, where not only atresias of the small bowel but also multiple mesenteric cysts of the small bowel were intraoperatively found.

Results: During surgery multiple mesenteric cysts, which are the cause of small bowel stenosis, were found in the proximal part of the small bowel. Nevertheless, the rest of a small bowel was evaluated and further 2 isolated type I atresias, clearly distally to the mesenteric cysts, were found.

Conclusions: To our knowledge, this has been the first case described where concomitantly small bowel atresia type I and mesenteric cysts were found in one patient. Even knowing that this is a rare combination of diagnosis we would like to point out that an enucleation of mesenteric cyst in case of bowel obstruction might not be enough and that the small bowel should always be carefully evaluated for further pathologies.