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CT-guided percutaneous catheter drainage of lymphocele complicating splenorenal anastomosis
Insights
CT-guided percutaneous catheter drainage successfully managed a large lymphocele after a Warren-Zeppa distal splenorenal venous anastomosis. This minimally invasive approach resolved the complication, avoiding major surgery.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- A lymphocele is a potential complication following vascular surgical procedures, particularly those involving lymphatic disruption.
- Distal splenorenal venous anastomosis, such as the Warren-Zeppa procedure, can be associated with lymphatic complications like chylous ascites and lymphocele formation.
Observation:
- A 31-year-old male with homozygous alpha 1-antitrypsin deficiency developed chylous ascites and a large lymphocele post-Warren-Zeppa anastomosis.
- The lymphocele measured 10.5 cm in diameter and persisted despite initial management.
Findings:
- CT-guided percutaneous catheter drainage was successfully employed to manage the large lymphocele.
- Lymphatic fluid drainage continued for 13 days, with complete resolution confirmed at 2.5 months post-procedure.
Implications:
- Percutaneous catheter drainage offers a minimally invasive and effective treatment option for lymphoceles complicating splenorenal venous anastomosis.
- This technique may obviate the need for more extensive surgical intervention in managing such post-operative complications.
Abstract:
We report the successful management by CT-guided percutaneous catheter drainage of a lymphocele complicating a Warren-Zeppa distal splenorenal venous anastomosis. The early postoperative course of this 31-year-old male with homozygous alpha 1-antitrypsin deficiency was complicated by chylous ascites and a large lymphocele demonstrable on CT scanning. The persistent 10.5 cm diameter lymphocele was drained percutaneously 5 weeks later by a CT-guided catheter. Drainage of lymph continued at decreasing rates for 13 days when the catheter was removed. Complete resolution of the lymphocele was confirmed at 2 1/2 months. The successful treatment of a lymphocele by percutaneous catheter drainage may obviate major surgery and has not been previously documented.