Rainbow Children’s Hospital Helps 7-Year-Old Recover from Rare Half-Kilo Congenital Cyst Wrapped Around Lifeline Intestinal Artery
Rainbow Children’s Hospital, India’s leading chain of pediatric multi-specialty and perinatal hospitals, has successfully treated a 7-year-old child who was initially admitted in Sholinganallur facility with persistent typhoid-like fever and abdominal pain, only to be diagnosed with a rare congenital cyst weighing nearly half a kilogram, deeply embedded in the intestine and wrapped around the Superior Mesenteric Artery (SMA) - the principal blood vessel supplying blood to almost the entire small intestine. The complex condition, which remained concealed despite initial investigations, required emergency surgery led by Dr. Abirami Krithiga, Consultant – Pediatric Surgeon and the team of doctors successfully removed the cyst while preserving the vital blood supply to the intestine. Following comprehensive postoperative care, the child has made a complete recovery, returned to a normal and healthy life.
The child had been living with the congenital cyst since birth, before it became symptomatic and was eventually detected during this acute illness. The cyst was diagnosed for the first time during this admission, as the child had never undergone an ultrasound scan previously. While ultrasound and CT scans detected a large abdominal cyst, its true size and close relationship with the major intestinal blood vessels remained undetected. Despite nearly two weeks of treatment, the fever persisted, followed by severe abdominal pain and green-coloured vomiting, raising concerns of intestinal obstruction and prompting emergency surgery. Initially planned laparoscopically, the procedure was converted to open surgery after the team discovered a giant 500-gram congenital chylolymphatic cyst tightly encasing the Superior Mesenteric Artery (SMA). The surgeons successfully removed the cyst while preserving the artery, sacrificing only 45 cm of the small intestine and thereby preventing complications such as Short Gut Syndrome. Following a brief postoperative chyle leak, which was managed conservatively with a temporary fat-free diet, the child recovered well, returned to school and is now back to playing football.
Speaking about the case, Dr. Abirami Krithiga, Consultant – Pediatric Surgeon, Rainbow Children's Hospital, said, "This was an extremely rare congenital chylolymphatic cyst, seen in nearly one out of every one lakh children. While imaging helped identify the cyst, its true complexity became apparent only during surgery. The biggest challenge was that the tumour had completely encased the Superior Mesenteric Artery, the lifeline of the small intestine.Damaging this artery could have resulted in loss of the intestine. Our objective was not just to remove the disease but also to preserve the child's future quality of life. We carefully balanced complete disease clearance with bowel preservation, avoiding Short Gut Syndrome while ensuring complete recovery."
The successful outcome was made possible through the collaborative efforts of a multidisciplinary team comprising Dr. Abirami Krithiga (Consultant – Pediatric Surgery), Dr. Karthick Narayanan and Dr. Bharath (Pediatric Intensive Care), Dr. Senthila (Pediatric Anaesthesia), Dr.Kirthika (Pediatric Anaesthesia) and Dr. Prasanna (Pediatric Radiology). From timely diagnosis and emergency intervention to critical care, nutritional management and postoperative rehabilitation, every specialty played a crucial role in ensuring the child's successful recovery.
Doctors at Rainbow Children's Hospital advise parents not to ignore persistent abdominal pain, unexplained fever, poor appetite, recurrent vomiting or unexplained weight loss in children. While not every stomach ache indicates a serious condition, congenital abdominal cysts often remain silent until they become large enough to cause complications. A simple, safe and radiation-free ultrasound can help detect such hidden abnormalities early, enabling timely treatment and preventing major surgical emergencies.
