Mesenteric Tumors Clinical Presentation

Updated: Jun 16, 2016
  • Author: Neal E Seymour, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Presentation

History and Physical Examination

Pain is the principal presenting symptom resulting in the discovery of a mesenteric mass. A palpable mass may also be present, although generally not without some abdominal pain. Nausea, vomiting, diarrhea, bloating, and constipation have also been described with mesenteric tumors.

Although most symptoms reflect a fairly indolent process, intestinal obstruction has been reported with benign and malignant mesenteric tumors. In the case of malignant tumors, this is generally secondary to aggressive local growth. In the case of benign tumors such as lipoma, the pathophysiology of obstruction is more complex.

Published descriptions of obstruction with mesenteric lipoma have implicated small-bowel encasement, small-bowel volvulus, or tumor infarction and obstruction due to the consequent inflammatory mass. Acute appendicitis as the result of torsion of a mesoappendiceal lipoma has also been described.

Clinical examination may reveal an abdominal mass. In the case of mesenteric lipoma, the tumor frequently cannot be appreciated by palpation.

In the case of mesenteric cysts, physical examination findings may reveal a mass lesion that is mobile only from the patient's right to left or left to right (Tillaux sign), in contrast to the findings with omental cysts, which should be freely mobile in all directions.