Doctor performs surgery on 56-yr-old woman with rare cystic condition

Upon further investigations, Dr Khandelwal found that the tumour was about 6 cm in diameter and was not arising from either the pancreas or the intestine

Fifty Six-year-old Shanta Sosa, a resident of Tardeo, recently underwent a surgery at Mumbai's iconic Bhatia Hospital for an extremely rare condition called chylous mesenteric cyst. The woman was experiencing very heavy uteral bleeding which led her to visit a local gynaecologist. A routine ultrasound revealed that there was a cystic tumour near her pancreas and the gynaecologist referred her to Dr Kamlesh Khandelwal, Laproscopic Surgeon, at Bhatia Hospital. The gynaecologist was of the opinion that the tumour needs to be taken care of first following which she could perform a hysterectomy.

Upon further investigations, Dr Khandelwal found that the tumour was about 6 cm in diameter and was not arising from either the pancreas or the intestine. It was instead in between the two. The tumour was also shifting blood vessels to the colon which made the situation a very critical zone to operate upon.

With this knowledge, Dr Khandelwal conducted a laparoscopic surgery over the patient and found that the cyst contained a milk-like fluid called chyle which is a lymphatic fluid. He and his team then separated out the whole cyst and removed it laparoscopically. The condition is so rare that so far roughly only about 19 cases have been reported across the world for it. Such a tumor is seen only in one in 1 lakh patients.

A major challenge was that the tumour was situated in an area which made it very difficult to tell whether it was benign or cancerous without removing it. Even after all the imaging like CT scan, MRI, PET scan, it was tough to say what kind of tumour it was and only a surgery could determine that.

Fortunately, for the patient, the tumour turned out to be a benign one and the surgery was successful. Dr Khandelwal had already informed the gynaecologist and a hysterectomy was then successfully performed on the patient as soon as the tumour was removed. The patient has already been discharged from the hospital and is now recuperating.

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