Abdominal pain: The black box. Retrospective evaluation of patients administered to the emergency department due to complicated lymphocyt

Abstract

Lymphocyst is mainly observed following extraperitoneal surgery. In this retrospective study, we aimed to determine the results of patients treated with percutaneous catheter drainage who referred to the emergency department due to lymphocyst complications. The examined group was consisted of 17 patients. All patients admitted to the emergency were suffering from abdominal pain. Ultrasonography (USG) was performed to all patients. Computerized tomography (CT) and magnetic resonance ımaging (MRI) were performed in 13 and 1 patient respectively. With the imaging evaluation complicated lymphocysts were detected. In 5 cases compression of urinary bladder, in 5 cases hydroureteronephrosis, in 2 cases compression of the left external iliac vein, in 1 case compression of the small and large intestine were observed. Percutaneous catheter drainage and sclerotherapy under ultrasonography and fluoroscopy guildance was performed to all cases in interventional radiology unit. To the best of our knowledge most of the lymphocysts were asymptomatic.Complicated lymphocysts may present as acute abdominal pain due to intraabdominal mass effect in patients having undergone surgery for gynecologic malignancy. If the lymphocyst is infected or becomes symptomatic due to compression of adjacent organ must be diagnosed and treated in early period. Clinical and radiological examinations are the key to the diagnosis of complicated lymphocyst. Emergency physicians should consider percutaneus catheter drainage as a treatment of choice.