Vera De Matos, MD; Pierre Russo, MD; Holly Hedrick, MD; David A. Piccoli, MD; Petar Mamula, MDSeries Editors: David A. Piccoli, MD; Petar Mamula, MD


August 03, 2005

Exploratory Laparotomy

Thus far, the extensive work-up has been inconclusive for the etiology of the ascites. The ultrasound showed fine septation, and the distribution of the abdominal fluid was not typical for ascites. Due to the presence of septations, a cystic mass was suspected. An exploratory laparotomy was performed and the findings are shown in Figures 4 and 5.

A large multicystic mass, 20 x 16 x 1.8 cm, weighing 1240 g was found beneath the peritoneum. It originated from the omentum and had a narrow pedicle. The walls were thin and translucent, and translucent septa were present.

Histologic analysis revealed cystic spaces lined by flat endothelial cells. Aggregates of lymphoid tissue were seen in the wall of the cysts, which were composed of vessels and adipose tissue. Bundles of smooth muscle were present focally underneath the endothelial lining.


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