Minimally invasive management of peritoneal inclusion cysts in paediatric patients
- Resource Type
- Article
- Authors
- Nwachukwu, Ijeoma; Ibrahim, Shimaa; Paul, Anu; Garriboli, Massimo; Taghizadeh, Arash; Cloke, Brianna; Karunanithy, Narayan; Mishra, Pankaj
- Source
- Journal of Pediatric Endoscopic Surgery; 20220101, Issue: Preprints p1-4, 4p
- Subject
- Language
- ISSN
- 25247875; 25247883
Background: Peritoneal inclusion cysts (PICs) are cyst-like structures that result from a non-neoplastic reactive mesothelial proliferation. It is mostly seen in females with functional ovaries. Aims: We describe the diagnosis and minimally invasive management of two adolescent girls with PICs after major reconstruction surgery for anorectal and genitourinary malformations. Case presentations: The first case is of a 14-year-old girl who underwent multiple abdominopelvic surgeries including cloacal reconstruction and renal transplantation. She presented with abdominal pain and fever. An abdominal computed tomography (CT) revealed a right pelvic fluid filled lesion (13.5 × 10 × 18.5 cm). Magnetic resonance imaging (MRI) pelvis confirmed a multicystic lesion surrounding the right ovary. She had a CT guided drainage of the cyst and oral progesterone. There was complete resolution on 1 year follow up ultrasound scan (USS). The second case is of a 17 year old girl who also had multiple abdominopelvic surgeries including anorectoplasty and bladder augmentation. She presented with an asymptomatic pelvic cyst. Abdominal USS showed a mostly midline septated cystic structure. Abdominopelvic MRI confirmed two pelvic cysts. Both ovaries were on either side of one of the lesions. She had ultrasound guided drainage and sclerotherapy. At 8 months, USS demonstrated recurrence. Conclusion: Minimally invasive percutaneous drainage with other adjuncts can offer symptomatic relief and short term resolution of large PICs in adolescents with a background of multiple abdominal operations.