Small Bowel Obstruction Associated With a Mesenteric Lymphatic Malformation: A Case Report

Mesenteric lymphatic malformations are rare benign lesions that may cause intestinal obstruction due to extraluminal compression. A 60-year-old man presented to his primary care physician with acute lower abdominal pain. Acute appendicitis was suspected based on clinical assessment, and conservative treatment was initiated. Although symptoms and laboratory findings improved, a palpable mass persisted in the right lower abdomen, and he was referred to another hospital. Further evaluation revealed small bowel obstruction, and he was transferred to our institution for further management. Contrast-enhanced abdominal computed tomography (CT) showed small bowel obstruction associated with extrinsic compression from an extraluminal mass lesion. Emergency surgery was performed on the second day after admission. Intraoperatively, multiple irregularly shaped and multilocular mass lesions of various sizes were observed in the small bowel mesentery, compressing the small intestine and resulting in obstruction. Partial resection of the small intestine including the involved lesions was performed. The postoperative course was uneventful, and the patient was discharged on postoperative day 9. Histopathological examination confirmed the diagnosis of mesenteric lymphatic malformation. Small bowel obstruction caused by extraluminal compression from a mesenteric lymphatic malformation is rare, particularly in adults. This case highlights the diagnostic challenge of extraluminal causes of bowel obstruction and supports surgical resection with complete excision as an effective treatment strategy. No recurrence or postoperative complications were observed during approximately two months of follow-up.