Hoa Tran Quoc, Cuong Nguyen Ngoc, My Thieu Thi Tra, Linh Le Tuan, Hoan Le, Canh Pham Hong, Tinh Trieu Quoc, Chi Tran Nguyen Khanh, Luu Doan Tien, Long Hoang
Urology Surgery Department, Hanoi Medical University Hospital, Hanoi, Vietnam.
Diagnostic Imaging and Interventional Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam.
Radiol Case Rep. 2023 Jan 5;18(3):1029-1032. doi: 10.1016/j.radcr.2022.12.013. eCollection 2023 Mar.
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.
乳糜性腹水是由于富含脂质的淋巴液漏入腹腔所致。大多数术后乳糜性腹水发生在腹主动脉手术后。然而，腹腔镜供体肾切除术后很少出现这种并发症。术后乳糜性腹水通常采用保守治疗或手术治疗，但可能需要进行淋巴栓塞。在此，我们报告了一名45岁男性患者，他在左供体肾切除术后1周因腹胀前来就诊。引流液呈乳白色，液体分析显示甘油三酯和乳糜微粒浓度很高，确诊为乳糜性腹水。患者接受了包括低脂饮食和液体引流在内的保守治疗，但引流液量持续很高（高达1500 - 2000毫升/24小时）。他接受了磁共振淋巴管造影和结内淋巴管造影，显示造影剂渗入腹部和左肾窝。我们对左腹膜后间隙淋巴管和淋巴管漏进行了栓塞。患者在干预后第五天出院。在本文中，我们展示了淋巴病变以及该技术的安全性和成功性。
