Small Bowel Volvulus Secondary to a Mesenteric Cystic Lymphangioma: A Case Report and Literature Review.

Mesenteric cystic lymphangioma (MCL) is a rare, benign lymphatic malformation that typically occurs in children and is infrequently encountered in adults. Although most cases are asymptomatic, complications such as volvulus, intracystic hemorrhage, or compression of adjacent structures may lead to acute abdominal presentations. We report the case of a 39-year-old male who presented with vomiting, abdominal pain, and absence of bowel movement for 48 hours. Imaging revealed a large multiloculated mesenteric cystic lesion associated with small bowel volvulus and signs of ischemia. Emergency laparotomy demonstrated a multicystic mass arising from the ileal mesentery, causing mesenteric rotation and obstruction. En bloc resection of the affected bowel segment and the mass was performed, followed by primary anastomosis. The postoperative course was uneventful. Histopathology confirmed a cystic lymphangioma without evidence of malignancy. MCL in adults is uncommon, and presentation with small bowel volvulus is exceptionally rare. Diagnosis is based primarily on imaging, with a CT scan being the modality of choice. Complete surgical resection remains the gold standard treatment, as incomplete excision is associated with high recurrence rates. Although rare, MCL should be included in the differential diagnosis of newly detected mesenteric cystic masses in adults. Early recognition and complete surgical excision are essential to prevent complications such as volvulus and to minimize recurrence.