A Case of Traumatic Retroperitoneal Chylous Lymphocyst

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 26; no. 3; pp. 451 - 454
• Main Authors: Tsukui, Taku, Tajiri, Takashi, Matsuhisa, Takeshi, Okihama, Yuji, Kimura, Yu, Matsuda, Takeshi, Egami, Kaku
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2006; 日本腹部救急医学会
• Subjects: リンパ嚢腫; 乳糜嚢胞; 外傷; 後腹膜
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.26.451

We report a patient with a retroperitoneal chylous lymphocyst developing after a blunt abdominal trauma. A 48-year -old woman fell down a 1-meter-high stepladder and struck her right abdomen. Three days after the fall, the abdominal swelling had gradually exacerbated, so the patient consulted our department. Abdominal echography and CT studies revealed a giant cyst in the right retroperitoneum; the patient was immediately admitted. Yellowish white chyle (2, 855ml) was collected by a percutaneous puncture of the cyst, and scintigraphy of the lymph vessel confirmed uptake, which was consistent with the cyst site. These results suggested a traumatic retroperitoneal chylous lymphocyst (lymphorrhea related to lymph vessel injury). Oral ingestion was restricted, and a percutaneous drain was inserted. The features of the drained fluid changed from chyle to transparent lymph. Outflow from the drain completely stopped 29 days after admission, and imaging confirmed the disappearance of the cyst. The drain was removed 33 days after admission. The patients was discharged from hospital, and the cyst did not recur.