Management of severe symptomatic abdominal lymphatic malformation complicated by abscess formation, protein-losing gastroenteropathy, and bleeding

• Published in: Annals of Pediatric Surgery Vol. 18; no. 1; pp. 92 - 8
• Main Authors: Ono, Hitoshi, Honda, Shohei, Miyagi, Hisayuki, Minato, Masashi, Ara, Momoko, Kondo, Takafumi, Okumura, Kazuyoshi, Okada, Tadao, Taketomi, Akinobu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2022; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Abdomen; Abscess formation; Abscesses; Ascites; Bleeding; Colon; Fever; Laparotomy; Management; Medicine; Medicine & Public Health; Mesentery; Original Research; Pain; Pancreas; Patients; Pediatrics; Protein-losing gastroenteropathy; Proteins; Sclerotherapy; Severe symptomatic abdominal lymphatic malformation; Small intestine; Surgery; Surgical outcomes; Veins & arteries; Colorado; Japan; Management; Protein-losing gastroenteropathy; Abscess formation; Bleeding; Severe symptomatic abdominal lymphatic malformation
• ISSN: 2090-5394; 1687-4137; 2090-5394
• DOI: 10.1186/s43159-022-00230-y

Background The optimal strategy for the management of patients with severe symptomatic abdominal lymphatic malformation (ALM) complicated by abscess formation, protein-losing gastroenteropathy, and bleeding has not yet been established. The present study aimed to determine an appropriate management for patients with severe symptomatic ALM, particularly for those with abdominal complications. Materials and methods Eight infants and young adults who underwent emergency surgery for ALM in our department, between the years 1997 and 2020, were selected for the study. We also evaluated and compared the operative procedures, operative timing, and postoperative surgical outcomes. Results Emergency resection was performed in all patients with bleeding. Some patients presented with ALMs that invaded the adjacent organs. Resections that included the involved organs were necessary to achieve full resolution in three patients. After evaluating the diagnostic modalities for symptomatic ALM, we also performed elective surgery for patients without bleeding. Conclusions Clinicians should be aware of severe symptomatic ALM with or without bleeding, as well as its associated complications, in order to select the best surgical management plan.