Balloon-occluded retrograde glue embolization for intractable lymphorrhea from bilateral iliac lymphatics following surgery for rectal cancer

Shigeyoshi Soga, Yohsuke Suyama, Hiroshi Shinmoto

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Lymphorrhea is a rare complication of rectal surgery. Although percutaneous embolization of thoracic or lymphatic ducts is now increasingly being reported for various types of lymphatic leakage, there are only sparse data on lymphatic interventions for lymphorrhea following rectal surgery. A novel balloon-occluded retrograde lymphatic embolization (BRLE) technique can be a simple and effective option for intractable lymphorrhea. We report a case of a man with infected lymphorrhea after rectal resection. Transperineal drainage was performed; however, lymphatic leakage persisted after 1 month of conservative treatment. Lymphangiography revealed multifocal leaks from bilateral iliac lymphatics. The proposed BRLE technique was performed via a balloon catheter inserted through the transperineal drainage. The balloon allowed occlusion of lymphatic outflow and forceful retrograde injection to achieve denser accumulation of n-butyl cyanoacrylate. Tight embolization of bilateral iliac lymphatics and drastic improvement of the leakage was achieved. To the best of our knowledge, this is the first report of percutaneous embolization for lymphorrhea after rectal surgery. This case supports the efficacy of the BRLE as a simple and effective therapeutic option for such persistent multifocal lymphatic leaks.

Original languageEnglish
Pages (from-to)371-374
Number of pages4
JournalRadiology Case Reports
Volume15
Issue number4
DOIs
Publication statusPublished - 2020 Apr
Externally publishedYes

Keywords

  • Balloon occlusion
  • Chylous ascites
  • Embolization
  • Lymphatic vessels
  • Lymphography
  • Rectal neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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