Articles

PRESSURIZED CONTRAST INJECTION IN A LYMPHOCELE CAN REVEAL AN EMBOLIZABLE LYMPHOPSEUDOANEURYSM IN POSTSURGICAL CHYLOUS ASCITES

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Abstract

This report describes the technique of lymphopseudoaneurysm (LPA) detection by pressurized contrast injection into a lymphocele, followed by image-guided embolization. A 37-year-old man with pancreatic neuroendocrine tumor, portal cavernoma, and liver metastasis underwent pancreaticoduodenectomy, right hepatectomy, lymphadenectomy, and left portal vein reconstruction. Postoperative course was complicated by refractory chylous ascites. Computed Tomography (CT) revealed a centrally located lymphocele in the abdominal cavity. Direct puncture of the lymphocele, followed by pressurized contrast injection revealed a tubular connection to a smaller retroperitoneal collection near the surgical site, which was considered to be the culprit LPA. After catheter directed embolization of this LPA with N-butyl-cyanoacrylate glue, chylous ascites ceased and abdominal drainage catheters were removed 12 days later.

Keywords: Lymphopseudoaneurysm, Lymphocele, Chylous ascites, Embolization

How to Cite:

Verhalleman, Q., Hartman, V., Roeyen, G. & Jardinet, T., (2025) “PRESSURIZED CONTRAST INJECTION IN A LYMPHOCELE CAN REVEAL AN EMBOLIZABLE LYMPHOPSEUDOANEURYSM IN POSTSURGICAL CHYLOUS ASCITES”, Lymphology 58(1), 23-28. doi: https://doi.org/10.2458/lymph.8730