Abdominal cysts

If your baby develops an abdominal cyst while in the womb, it can be alarming. Our fetal surgeons closely monitor your baby during your pregnancy. We have expertise in minimally invasive procedures to treat all types of abdominal cysts in stomachs.

Learn more about what to expect when you come to us for your baby’s care.

What are abdominal cysts?

Cysts are fluid-filled sacs of tissue that can vary in size, severity, location and symptoms. Fetal abdominal cysts develop in a baby’s abdomen (belly) before birth and can cause problems if they grow very large. Large cysts put pressure on nearby organs as the baby develops, causing complications such as:

• Blockage in the digestive tract (tubes through which nutrients pass, from the mouth to the anus)
• Torsion (twisting) of an organ, such as an ovary, which can cut off its blood supply
• Excess amniotic fluid (protective liquid surrounding the baby in the womb)

Types of cysts in stomachs

Babies can develop one or more cysts in their stomachs as they grow in the womb. The most common types of fetal abdominal cysts include:

• Choledochal: Cysts that form in the stomach bile ducts, which carry bile (a digestive fluid) from the liver to the gall bladder and small intestine
• Duplication or gastrointestinal: Portions of extra tissue that form in the digestive tract anywhere from the esophagus to the intestines
• Genitourinary: Cysts that form in the urinary tract, which includes the kidneys, ureters (tube connecting the kidney and the bladder), the bladder and the urethra
• Mesenteric: Cysts that form in the mesentery, a membrane surrounding the intestines that connects them to the abdominal wall
• Ovarian: Cysts that develop on an ovary

What causes abdominal cysts?

The causes of most abdominal cysts are generally unknown. Medical experts believe that ovarian cysts might result from exposure to the mother’s hormones during pregnancy.

Abdominal cysts symptoms and signs

Before birth, fetal abdominal cysts don’t usually cause symptoms. Symptoms and signs that can develop in a newborn include:

• Crying because of pain
• Difficulty feeding
• Difficulty passing urine and feces (stool)
• Jaundice (yellowish color of the skin and eyes)
• Soft mass in the baby’s belly
• Vomiting

Symptoms of a very large cyst

Very large cysts (two or more inches wide) can cause:

• Difficult delivery
• Difficulty breathing for the baby if the cyst has pressed on the fetus's diaphragm, preventing the lungs from expanding enough

Abdominal cysts diagnosis

A routine ultrasound during pregnancy can show an abdominal cyst in the fetus. Your doctor may order additional imaging for more information about the cyst’s size and location. They may recommend an ultrasound that provides greater detail, an ultrafast fetal MRI or a computed tomography (CT) scan. We may also refer you to our genetics program for a consultation and evaluation.

Sometimes, cysts go unnoticed until babies are born or grow older and develop symptoms. We use the same imaging techniques – ultrasound, MRI or CT – for newborns, infants and older children. Find out more about the imaging methods we use to diagnose fetal conditions.

What is an anechoic cyst?

When we perform an ultrasound on your baby’s abdominal cyst, the ultrasound device sends sound waves toward the cyst. After the results have been read, the cyst will be described as an anechoic cyst, hypoechoic cyst or hyperechoic cyst depending on how many echoes (sound waves) it sends back.

• Anechoic cyst: Sends back no sound waves. They’re often filled with fluid and are usually benign.
• Hypoechoic cyst: Sends back few sound waves. They’re often solid masses of dense tissue and may be cancerous.
• Hyperechoic cyst: Sends back many sound waves. They’re not as dense as hypoechoic cysts and are usually benign. May contain fat, air, or fluid.

Abdominal cysts treatment

If we find an abdominal cyst during pregnancy, we monitor your baby with ultrasounds at regular intervals. We keep an eye on the cyst’s size and any changes it undergoes to help you make decisions about vaginal birth or cesarean birth. We can deliver most babies vaginally.

Sometimes, fetal abdominal cysts go away on their own before birth and don’t require treatment. Some newborns require surgery (cystectomy) to remove a cyst causing symptoms. If we can’t remove a cyst completely, we may drain it or remove portions.

Our skilled pediatric surgeons have experience in minimally invasive laparoscopic procedures for cystectomy. These techniques use small incisions, a scope (narrow, flexible tube with a light and camera) and very small instruments to remove cysts.