Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan.
Taiwan J Obstet Gynecol. 2024 Sep;63(5):741-744. doi: 10.1016/j.tjog.2024.04.017.
We present an unusual case of a small para-aortic lymphocele causing duodenal stenosis after lymphadenectomy and discuss its treatment.
Our case involved a 57-year-old woman with endometrial cancer who underwent surgery, including para-aortic lymphadenectomy. On postoperative day 7, projectile vomiting occurred. Computed tomography (CT) revealed a small lymphocele in the dorsal duodenum, causing duodenal stenosis. Transpercutaneous and transduodenal puncture or surgical procedures were difficult because the cyst was too small. Per endoscopic and gastrointestinal series findings on the postoperative day 22, a liquid diet was presumed to be able to pass through the narrow portion. Hence, concentrated liquid food was administered orally; no vomiting occurred. At 2 months postoperatively, CT showed no lymphocele.
Conservative treatment involving waiting for spontaneous lymphocele reduction with a concentrated fluid diet may be considered in such cases if fluid passage is confirmed with endoscopy and gastrointestinal series.
我们报告一例罕见的小副主动脉淋巴囊肿在淋巴结切除术后引起十二指肠狭窄,并讨论其治疗方法。
我们的病例涉及一名 57 岁女性,患有子宫内膜癌,接受了手术,包括副主动脉淋巴结切除术。术后第 7 天,出现喷射性呕吐。计算机断层扫描(CT)显示在十二指肠背部有一个小的淋巴囊肿,导致十二指肠狭窄。由于囊肿太小,经皮和经十二指肠穿刺或手术治疗都很困难。根据术后第 22 天的内镜和胃肠道系列检查结果,推测可以通过狭窄部位的是浓稠液体饮食。因此,给予口服浓缩液体食物;没有发生呕吐。术后 2 个月,CT 显示无淋巴囊肿。
如果内镜和胃肠道系列检查证实液体可以通过,对于这种情况,可以考虑采用保守治疗,即等待淋巴囊肿自行缩小并给予浓稠的液体饮食。