Peritoneal Inclusion Cyst in a Young Patient With a Long History of Abdominal Surgeries: A Case Report

Our plain-English summary of Peritoneal Inclusion Cyst in a Young Patient With a Long History of Abdominal Surgeries: A Case Report, by J.O. AlTamimi, E.A. Alzahrani, A. Fallatah, et al (Curēus, 2023).

The study

• Authors: J.O. AlTamimi, E.A. Alzahrani, A. Fallatah, L.A. Alhakami, B.E. Bokhari
• Journal: Curēus
• Published: 2023;15(2):e35230
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Peritoneal inclusion cysts (PICs) are reactive, fluid-filled lesions of the peritoneal lining, usually affecting women of reproductive age and with previous abdominal surgeries. Paraovarian cysts, hydrosalpinx, and low-grade cystic mesothelioma are usually considered in the differential diagnosis of PICs. In this case report, we present an 18-year-old female with a known case of bladder exstrophy and chronic urinary incontinence and a previous history of surgical bladder repair. She presented to the emergency department (ED) with urinary incontinence and lower abdominal pain. A computed tomography was ordered for her to rule out hydronephrosis, and incidentally, ovarian cysts were discovered that were then bilaterally excised via laparotomy. Our case report emphasizes the significance of considering such a diagnosis when coming across patients whose risk factors and symptoms match the diagnosis.

Copyright © 2023, AlTamimi et al.

In plain English

This case report describes one patient and does not discuss asbestos. The patient, an 18-year-old female with bladder exstrophy and chronic urinary incontinence, had bladder repair in 2016 and bladder neck reconstruction in 2018. She came to the emergency department with urinary retention, lower abdominal pain and painful urination. A CT scan ordered to rule out hydronephrosis incidentally showed cystic masses on both sides along the adnexal vessels and ovaries, and MRI suggested peritoneal inclusion cysts. Drainage removed brown fluid with no malignant cells, but the fluid reaccumulated after two weeks. Both cysts were then removed by open surgery (laparotomy). Severe adhesions were found and the sigmoid colon suffered a laceration of less than 1 cm. A colocutaneous fistula and pelvic fluid collections developed afterward and were treated. Pathology confirmed multilocular peritoneal inclusion cysts on both sides. The authors considered prior surgery the most likely cause. They concluded that this diagnosis should be considered in patients whose risk factors and symptoms match it. Low-grade cystic mesothelioma is mentioned only as a condition usually considered in the differential diagnosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single patient)
• Who was studied: One 18-year-old female with bladder exstrophy and chronic urinary incontinence who had bladder repair (2016) and bladder neck reconstruction (2018)
• Exposure: No asbestos or fiber exposure is described. The suspected cause the authors discussed was disruption of the peritoneum from prior surgery.
• Main results:
  • CT, done to rule out hydronephrosis, incidentally showed bilateral cystic masses. The right mass measured 5.8 cm × 12 cm × 2.4 cm and the left 9 cm × 6 cm × 15 cm.
  • MRI showed non-complicated cystic lesions on both sides, most likely peritoneal inclusion cysts.
  • Image-guided drainage yielded brown fluid with no malignant cells.
  • Two weeks later symptoms returned, and repeat CT showed fluid reaccumulating within the cyst.
  • During laparotomy there were severe adhesions and a sigmoid colon laceration of less than 1 cm.
  • After surgery a colocutaneous fistula and pelvic collections developed. The fistula resolved with conservative management over two weeks, and the collections were drained.
  • Pathology confirmed multilocular peritoneal inclusion cysts on both sides.
• The authors' conclusion: The authors concluded that peritoneal inclusion cysts should be considered in patients whose risk factors and symptoms match the diagnosis.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Differential Diagnosis, Laparotomy.

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• Collagenous Spherulosis in Well-Differentiated Papillary Mesothelioma in a Female With Multilocular Peritoneal Inclusion Cysts — B. AbdullGaffar, L.G. Raman (2019)
• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain in a young male: case report and review of the literature — S. Gussago, P. Spina, et al. (2019)

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