Management, Trends, and Recommendations for Intra-abdominal Lymphatic Malformations: A Single-Center Retrospective...

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Pediatric Surgery

Background:

• Intra-abdominal lymphatic malformations (ILM) are rare vascular anomalies originating from the mesentery, omentum, or retroperitoneum.
• ILM can cause significant abdominal symptoms or be found incidentally, with unclear management guidelines and prognosis.
• This study aims to characterize ILM presentations, treatments, and outcomes.

Purpose of the Study:

• To describe and characterize common presentations of intra-abdominal lymphatic malformations (ILM).
• To evaluate various treatment modalities for ILM, including medical therapy, interventional procedures, and surgery.
• To assess treatment response and complication rates in patients with ILM.

Main Methods:

• Retrospective chart review of non-solid organ ILM patients treated at a tertiary vascular anomalies clinic.
• Descriptive statistical analysis of patient demographics, symptoms, treatments, and outcomes.
• Study classified as a Level III treatment study.

Main Results:

• Fifty-six patients with ILM were identified, with 37% having associated lymphatic or vascular malformations.
• Abdominal symptoms were common, including pain (32%), obstruction (9%), and distention (7%).
• Sclerotherapy (27%) showed a 67% symptom resolution rate; sirolimus (39%) was also effective. Surgery (27%) was reserved for obstruction or treatment failure, with 32% requiring bowel resection.

Conclusions:

• Most ILM patients exhibit abdominal symptoms and co-occurring vascular anomalies.
• Interventional procedures like sclerotherapy and medical management with sirolimus are safe, effective first-line ILM therapies.
• Surgical intervention for ILM should be reserved for cases of acute bowel obstruction or when less invasive treatments fail.