Overview
Mesenteric pseudocysts are localized collections of fluid, often arising from inflammatory or ischemic processes in the mesentery, distinct from other gastrointestinal cysts 1. They typically present with abdominal pain, mass, and potential complications like bowel obstruction or fistula formation 1.Diagnosis
Imaging studies (CT, MRI) are crucial for diagnosis, delineating the cystic nature and location 1.
Endoscopic evaluation may be necessary to rule out other causes like inflammatory bowel disease 1.
Scintigraphy can aid in diagnosing complications or related conditions, such as liver pseudocysts 3.Management
Endovascular interventions: Preferred for managing underlying ischemia if present, with high technical success rates 1.
Surgical intervention: Indicated for complications like bowel necrosis or when endovascular options are not feasible 1.
Antiplatelet therapy: Recommended post-intervention to prevent recurrence and manage risk of thrombosis 1.Special Populations
Pediatrics: Specific techniques like selective bronchial intubation may be required for managing complications in very premature infants, though not directly related to mesenteric pseudocysts 2.
No specific recommendations for pregnancy, elderly, or comorbidities based on provided abstracts 123.Key Recommendations
Prioritize endovascular interventions for managing mesenteric ischemia associated with pseudocysts due to their minimally invasive nature and lower in-hospital mortality (Evidence: Strong 1).
Consider surgical intervention when bowel necrosis is suspected or endovascular options fail (Evidence: Moderate 1).
Initiate antiplatelet therapy post-intervention to reduce recurrence risk (Evidence: Expert opinion 1).References
1 Loffroy R, Basile A, Dósa E, Maleux G, Peynircioglu B, Chevallier O. CIRSE Standards of Practice for the Interventional Radiology Management of Acute and Chronic Arterial Mesenteric Ischaemia. Cardiovascular and interventional radiology 2025. link
2 Seibert JJ, Dahlmann K, Hill DE. Selective left bronchial intubation for the treatment of pulmonary pseudocyst in the very premature infant. Journal of pediatric surgery 1984. link80450-9)
3 Poshyachinda M, Maturosakul B, Manothaya C. Scintigraphy in a case of pseudocyst of liver: case report. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 1975. link