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Lymphatic malformation causing intractable chylorrhagia.

A Kayikçioğlu1, S Karamürsel, T Safak

  • 1Plastic and Reconstructive Surgery Department, Hacettepe University Faculty of Medicine, Ankara, Turkey. akayikci@hacettepe.edu.tr

Plastic and Reconstructive Surgery
|April 1, 2000
PubMed
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Lymphatic malformations can cause rare chyle reflux and intractable chylorrhagia. A novel latissimus dorsi myocutaneous flap successfully managed a complex case, restoring lymphatic flow.

Area of Science:

  • Vascular Surgery
  • Pediatric Surgery
  • Developmental Biology

Background:

  • Lymphatic malformations are congenital anomalies often presenting in infancy or early childhood.
  • Surgical excision of lymphatic malformations in the upper leg and lower trunk is challenging due to lesion size and retroperitoneal extension.
  • Chyle reflux, typically linked to lymphedema, has not been previously associated with lymphatic malformations.

Observation:

  • A case of intrapelvic retroperitoneal lymphatic malformation with gluteal-thigh soft-tissue involvement presented with intractable chylorrhagia.
  • This represents a rare instance of chyle reflux directly caused by a lymphatic malformation.

Findings:

  • Subtotal excision of the lymphatic malformation was performed.
  • A distally based, peninsular latissimus dorsi myocutaneous flap was utilized to reconstruct the defect.

Related Experiment Videos

  • The flap effectively filled the surgical void and facilitated lymphatic reconstruction.

    • Implications:

    • This case highlights a novel surgical approach for managing complex lymphatic malformations with associated chylorrhagia.
    • The latissimus dorsi myocutaneous flap offers a viable solution for restoring lymphatic continuity and managing chyle reflux.
    • Further research into the etiology and management of lymphatic malformation-induced chyle reflux is warranted.