Mesenteric cyst associated with tuberculosis in a child

Mesenteric cyst is a rare occurrence in children and there are few reports of its association with abdominal tuberculosis (TB). We present the case of a 9-year-old boy with a 4-month history of fever, progressive abdominal pain and swelling, weight loss and no prior immunisation. There was a history of contact with a chronically coughing adult. He had massive ascites at presentation; the ascitic fluid was exudative but negative for TB. Radiological imaging showed left lobar consolidation on chest radiograph and a ring-enhancing hypodense cystic lesion on the jejunal mesentery on abdominal computed tomography scan. A clinical diagnosis of disseminated TB with mesenteric cyst was made. He was commenced on TB treatment with complete resolution of signs and symptoms by the eighth month of therapy. Mesenteric cysts resulting from TB may resolve over time with standard treatment for TB, as in the case of our patient, without the need for surgical intervention.