A previously healthy, 4-year-old boy was admitted to the hospital with a 2-week history of diffuse, intermittent abdominal pain. He had no vomiting, diarrhea, or fever. Four days prior to admission, ecchymosis of the right scrotum was noted. This increased in intensity the day prior to admission.
Physical examination was remarkable for a large, firm, mobile, nontender abdominal mass in the middle and right lower abdomen. There were ecchymoses of the scrotum, and the right testicle was slightly larger than the left. Laboratory evaluation revealed a hematocrit level of 0.29. Urinalysis and coagulation studies were normal. Abdominal roentgenogram (Fig 1), abdominal ultrasound (Fig 2), and computed tomographic scan (Fig 3) of the abdomen with contrast were obtained.
Denouement and Discussion
Mesenteric Cyst With Hemorrhage
Mesenteric cysts are an uncommon origin of abdominal mass in children. These are simple cysts with no apparent connections to normal anatomic structures.
Gallagher PG, Kirks D, Wood BP. Radiological Case of the Month. Am J Dis Child. 1990;144(7):793-794. doi:10.1001/archpedi.1990.02150310061028