Cases reported "Lymphocele"

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11/31. Multicystic lymphatic malformations of the penis. Report of two cases.

    Two patients presented with multicystic lymphatic malformations of the penis. These were congenital and progressive, and both were successfully treated by excision after injection of methylene blue.
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12/31. Lymphatic malformation of the parapharyngeal space.

    Lymphatic malformations are rare benign congenital lesions. A 28-month-old girl presented with a parapharyngeal lymphatic malformation. A cystic lesion had been diagnosed at 18 weeks' gestation by ultrasonography and she had been followed up conservatively until her referral to our department. We used a transcervical approach to excise the parapharyngeal lesion and 1 year later, there was no sign of recurrence.
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13/31. Early sonographic diagnosis of fetal cystic hygroma colli.

    Fetal cystic hygroma colli (FCHC) is a congenital malformation of the lymphatic system which develops as a result of failure of the communication between the jugular lymphatic canal and the internal jugular vein. The diagnosis is usually made by ultrasound in the second trimester of pregnancy by the demonstration of a multiseptate, thin-walled cystic mass appearing posterolaterally in position to the fetal head and neck region. In this report we present two cases of FCHC diagnosed by transabdominal ultrasound in the first trimester of pregnancy. In one case, chorionic villus sampling revealed a 45,X karyotype, the fetus became progressively hydropic and died at 15 1/2 weeks. In the other, the spontaneous resolution of a nonseptated FCHC in a fetus with normal karyotype was documented, resulting in the delivery of a healthy infant a term. Fetal karyotyping, a careful search for other anomalies that may affect fetal survival, and a close sonographic follow-up in cases of FCHC are advocated for an accurate diagnosis and genetic counselling.
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ranking = 0.4
keywords = lymphatic
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14/31. Successful treatment of refractory hepatic lymphorrhea after gastrectomy for early gastric cancer, using surgical ligation and subsequent OK-432 (picibanil) sclerotherapy.

    Postoperative hepatic lymphorrhea is a very rare complication after abdominal surgery. Hepatic lymphorrhea, not containing chyle, involves an internal lymph fistula between the lymphatic channels toward the cisterna chyli and the peritoneal cavity. Over the past 20 years, 17 cases have been reported in japan. Here, we report a further case, of a patient with successfully treated intractable hepatic lymphorrhea following gastrectomy for early gastric cancer. We review 18 cases, including the present case, with respect to the management of postoperative lymphorrhea refractory to conventional medical treatment.
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keywords = lymphatic
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15/31. Treatment of lymphocele and lymphatic fistula following renal transplantation by laparoscopic peritoneal window.

    Symptomatic lymphoceles that occur after renal transplantation are managed best by surgical marsupialization with drainage into the peritoneal cavity. We report a case of post-transplant lymphocele associated with a cutaneous lymphatic fistula, which was successfully treated using laparoscopic drainage without a major surgical incision. With this new technique we were able to remove an ellipse of peritoneal wall along with the adjacent lymphocele wall and to lyse all internal lymphocele loculations, allowing for the free flow of lymph into the peritoneal cavity and cessation of cutaneous leakage. We believe that, when technically possible, laparoscopic internal peritoneal drainage is an effective procedure for managing simple and complex symptomatic lymphoceles with or without associated lymphatic fistulas, provided there is no evidence of infection.
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16/31. Surgical management of groin lymphatic complications after arterial bypass surgery.

    BACKGROUND: The authors undertook a retrospective study to define the incidence of groin wound lymphatic complications at their institution and to review their experience with treatment of the complications. methods: Operating room records and patient databases of the two primary vascular surgeons at an academic teaching institution were reviewed retrospectively. groin lymphatic complications were diagnosed by clinical presentation and confirmed with noninvasive imaging. Surgical management included percutaneous methods, ligation of leaking lymphatics, excision, and/or muscle flap coverage. RESULTS: From June of 1989 to June of 2002, 538 patients had arterial revascularization procedures involving the groin. Twenty-seven patients with groin wound lymphatic complications were identified; seven of them had bilateral complications, for a total of 34 complication sites. Common comorbidities included hypertension, coronary artery disease, chronic renal insufficiency, and tobacco use. The majority (85 percent) had artificial material in the bypass graft, and 10 patients had undergone a previous operation at the same site. The mean time to identification of groin lymphatic complications after vascular surgery was 14 days. Common presentations included swelling (n = 16), drainage (n = 13), erythema (n = 4), and leg edema (n = 1). At presentation, 17 patients (63 percent) were receiving antibiotics and 21 (78 percent) were receiving anticoagulation or antiplatelet therapy. Of the 34 complication sites, 12 were managed with drainage or excision and 22 with muscle flap surgery, 10 of which failed less aggressive therapy. Muscle flaps included the gracilis (n = 19), sartorius (n = 1), rectus abdominis (n = 1), and rectus femoris muscles (n = 1). Operative cultures were positive in 23 of the 34 groin lymphatic complication sites. A biopsy specimen of a healed gracilis flap obtained at 1 year demonstrated notable lymphatic channels, possibly supporting theories that rotated muscle becomes a lymphatic conduit. CONCLUSIONS: The authors found that muscle flap surgery provides single-intervention therapy for successful resolution of lymphoceles, with a low complication rate and fairly rapid recovery in a high-risk patient population. Flaps also salvage cases that have failed conservative therapy and provide hardy coverage for a wound bed that is often infected.
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ranking = 2.4
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17/31. Graft loss due to percutaneous sclerotherapy of a lymphocele using acetic acid after renal transplantation.

    Development of lymphoceles after renal transplantation is a well-described complication that occurs in up to 40% of recipients. The gold standard approach for the treatment of symptomatic cases is not well defined yet. Management options include simple aspiration, marsupialization by a laparotomy or laparoscopy, and percutaneous sclerotherapy using different chemical agents. Those approaches can be associated, and they depend on type, dimension, and localization of the lymphocele. Percutaneous sclerotherapy is considered to be less invasive than the surgical approach; it can be used safely and effectively, with low morbidity, in huge, rapidly accumulating lymphoceles. Moreover, this approach is highly successful, and the complication rate is acceptable; the major drawback is a recurrence rate close to 20%. We herewith report a renal transplant case in which the patient developed a symptomatic lymphocele that was initially treated by ultrasound-guided percutaneous sclerotherapy with ethanol and thereafter using acetic acid for early recurrence. A few hours after injection of acetic acid in the lymphatic cavity, the patient started to complain of acute pain localized to the renal graft and fever. An ultrasound of the abdomen revealed thrombosis of the renal vein and artery. The patient was immediately taken to the operating room, where the diagnosis of vascular thrombosis was confirmed and the graft was urgently explanted. In conclusion, we strongly suggest avoiding the use of acetic acid as a slerosating agent for the percutaneous treatment of post-renal transplant lymphocele because, based on our experience, it could be complicated by vascular thrombosis of the kidney, ending in graft loss.
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ranking = 0.2
keywords = lymphatic
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18/31. Retroperitoneal laparoscopic management of a lymphocele after abdominal aortic surgery: a case report.

    A retroperitoneal lymphocele is a rare complication of abdominal aortic surgery. We present a case of 77-year-old man who developed a retroperitoneal lymphocele 14 days after undergoing graft replacement for an abdominal aortic aneurysm. paracentesis showed a white and turbid fluid that was determined to be chyle. Conservative therapy, including percutaneous drainage, fasting, and total parenteral nutrition, was unsuccessful. Retroperitoneal laparoscopic ligation of the leaking lymphatics was performed on postoperative day 33. The postoperative course was satisfactory. The laparoscopic approach to retroperitoneal lymphocele treatment after abdominal aortic repair is a safe and minimally invasive therapeutic method.
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ranking = 0.2
keywords = lymphatic
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19/31. Post-transplant lymphocele: an unusual cause of acute urinary retention mimicking urethral injury.

    Retroperitoneal pelvic lymphoceles are one of the most common complications following renal transplantation, and usually present with a palpable mass, ipsilateral leg edema, hydronephrosis caused by ureteral obstruction, decreased renal function and cutaneous lymphatic fistula. However, lymphocele rarely causes acute urinary retention. In this study, we describe a case of a patient who developed acute urinary retention after renal transplantation mimicking urethral injury. When a transplanted patient demonstrates the inability to void, one should consider bladder outlet obstruction resulting from lymphocele as a possible cause.
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ranking = 0.2
keywords = lymphatic
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20/31. chylous ascites and lymphocyst management by peritoneovenous shunt.

    Although lymphocyst (retroperitoneal lymphocele) is not an uncommon complication after retroperitoneal surgery, with a reported incidence ranging from 0.6% to 48%, the occurrence of chylous ascites is a rare phenomenon. Most reports are anecdotal, and hospital records list the incidence of diagnosis as 0.001% of admissions. diagnosis of chylous ascites is usually not difficult, inasmuch as aspiration and chemical analysis of the fluid yield the answer. Visualization of retroperitoneal fluid collection by computerized tomography or ultrasonography, however, does always raise the possibility of recurrence of tumor in cases where the primary operation was for cancer. Treatment of smaller lesions can be expectant. Respiratory exercises causing an increase in negative intrathoracic pressure may aid in the movement of fluid through the lymphatics. For larger collections, elemental diets and total parenteral nutrition are also often enough, but surgery is sometimes required. Simple insertion of a peritoneovenous shunt, as in this patient, can be as effective as major operations such as identification and ligation of the offending lymphatic or marsupialization of the cyst.
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ranking = 0.4
keywords = lymphatic
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