Intra-abdominal cystic lymphangioma in an infant
The present case has been reported in the Journal of Pediatrics. A term baby boy was delivered by elective caesarean delivery owing to increasing size of a cystic mass in the abdomen, which had been first detected antenatally using ultrasound examination.

The differential diagnosis based on this antenatal scan was lymphangioma, mesenteric cyst, meconium peritonitis, meconium cyst, or bowel obstruction secondary to perforation. Fetal magnetic resonance imaging (T1-weighted) showed possible free fluid in the anterior abdominal cavity extending to the left side of the abdomen where umbilical vessels were seen traversing the fluid.

Deep to the fluid, nondilated loops of small bowel and meconium-filled nondilated large bowel extending to the rectum were identified, showing no evidence of bowel obstruction or perforation.

A postnatal abdominal ultrasound scan identified a 7.4 × 4.0-cm multiloculated cystic lesion with thin septae and no vascularity. He underwent a laparotomy, which revealed a multiloculated cystic mass arising from the jejunal mesentery encasing 15-cm of bowel.

The mass was resected with the affected bowel and a primary anastomosis performed. Histopathology confirmed the diagnosis of a benign lymphangioma.

Learning Points:-
- The treatment of choice for ICL is surgical excision. Other treatments described in the literature are sclerotherapy and medical therapy with sirolimus.

- However, these treatments are more commonly used for lymphangiomas located in anatomic areas where surgical access may prove challenging, such as in the head and neck as well as mediastinum.

- If left untreated, ICL may result in an acute abdomen, especially in children.

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