Chylous ascites after donor nephrectomy: MR lymphangiography and lymphatic embolization treatment

Radiology Case Reports

article

Tran Quoc Hoa¹  Nguyen Ngoc Cuong¹  Thieu Thi Tra My¹  Le Tuan Linh¹  Le Hoan¹  Pham Hong Canh¹  Trieu Quoc Tinh¹  Tran Nguyen Khanh Chi¹  Doan Tien Luu¹  Hoang Long¹ 

[1] Urology Surgery Department, Hanoi Medical University Hospital

关键词: Chylous ascites;    Living donor nephrectomy;    Lymphatic embolization;    Lymphangiography;   

DOI  :  10.1016/j.radcr.2022.12.013

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Abstracts Chylous ascites results from the leakage of lipid-rich lymphatic fluid into the peritoneal cavity. Most postsurgical chylous ascites occurs following abdominal aortic surgeries. However, rarely, it is a complication after laparoscopic donor nephrectomy. Postsurgical chylous ascites are often managed with conservative treatment or surgery, but lymphatic embolization may be required. Here, we presented a 45-year-old male patient who was referred for abdominal distension for 1 week after left donor nephrectomy. The drain fluid was milky and fluid analysis revealed high concentrations of triglycerides and chylomicron, confirming diagnosis of chylous ascites. The patient was treated with conservative therapy including a low-fat diet and fluid drainage but continued to have high draining output (up to 1500-2000 mL/24 h). He underwent magnetic resonance lymphangiography and intranodal lymphangiography, revealing extravasation of contrast into the abdomen and the left renal fossa. We embolized the interstitial lymphatic of the left retroperitoneal and lymphatic vessels leak. The patient was discharged from hospital at the fifth day after intervention. In this article, we demonstrate lymphatic lesions, the safety, and success of this technique.

【 授权许可】

CC BY|CC BY-NC-ND