  |
|
 |
|
Case Report
| ||||||
| The management of a recurrent lymphocele following a brachiobasilic fistula superficialization | ||||||
| Ahmed Mohamed Elhassan Elfaki Osman1, Saif Eldin Mohammed Ali Ibrahim2 | ||||||
|
1MBBS, Ibn Sina Specialized Hospital - Senior House-officer, Unit of Vascular and Endovascular Surgery, Ibn Sina Specialized Hospital, Khartoum, Sudan.
2MBBS, MD, MRCS (ENG); D.MAS; F.MAS; F. Vasc/Endovasc (MAL), Ibn Sina Specialized Hospital - Head, Unit of Vascular and Endovascular Surgery, Ibn Sina Specialized Hospital, Khartoum, Sudan. | ||||||
| ||||||
|
[HTML Full Text]
[PDF Full Text]
[Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar] 
|
| How to cite this article |
| Osman AMEE, Ibrahim SMA. The management of a recurrent lymphocele following a brachiobasilic fistula superficialization. Int J Case Rep Images 2014;5(12):849–853. |
|
Abstract
|
|
Introduction:
A lymphocele is defined as a collection of lymphatic fluid in a space within the body not bordered by epithelial linings. They usually occur following surgeries due to iatrogenic disruption of the lymphatic vessels or following an injury in which there is destruction of the lymphatic vessels. Lymphoceles frequently arise following extensive pelvic surgeries, especially gynecological oncological surgeries, and renal transplant surgery. Other surgeries associated with lymphocele formation include open abdominal aortic aneurysm repair, mediastinal and peripheral vascular surgery.
Case Report: A 65-year-old male with end-stage renal disease (ESRD), presented with an upper arm lymphocele one month after basilic vein superficialization with no other complaints. On examination, all upper extremity pulses were intact (2+) and the arteriovenous fistula had a positive thrill. The swelling was cystic, measuring about 10x20 cm. On greyscale ultrasound, the swelling appeared hypoechoic. Doppler ultrasonography confirmed the patency of the fistula. His management included lymphatic fluid aspiration and povidone iodine sclerotherapy sessions. This regimen was carried out for four consecutive weeks; the same amount of lymphatic fluid was aspirated weekly, indicating the inadequacy of the procedure. On the fifth session, after aspirating the same amount of lymphatic fluid and sclerotherapy, external pressure was applied through a gauze stitched between two skin folds and was left in place for five days. There was no recurrence of the lymphocele after stitch removal. Therefore, we are reporting this case because we strongly believe that aspiration of lymphatic fluid with sclerotherapy complemented by fixed external pressure provided a definitive treatment for a recurrent upper-arm lymphocele. Conclusion: Complications arising after peripheral vascular surgeries are vast. Lymphoceles occur less frequently than thrombosis or aneurysms. However, the diagnosis should be kept in mind in any patient presenting with a swelling following recent vascular surgery. With regards to the studies conducted on management of postoperative lymphoceles, some authors advocate the approach of consecutive drain-and-sclerotize sessions while others support more conservative methods such as immobilization and pressure dressings. | |
|
Keywords:
Basilic vein superficialization,
Lymphocele, External pressure, Brachiobasilic fistula, Arteriovenous fistula
| |
|
[HTML Full Text]
[PDF Full Text]
|
|
Author Contributions
Ahmed Mohamed Elhassan Elfaki Osman – Acquisition of data, Drafting the article, Final approval of the version to be published Saif-Eldin Mohammed Ali Ibrahim – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published |
|
Guarantor of submission
The corresponding author is the guarantor of submission. |
|
Source of support
None |
|
Conflict of interest
Authors declare no conflict of interest. |
|
Copyright
© 2014 Ahmed Mohamed Elhassan Elfaki Osman et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
|
|
|
About The Authors
| |||
| |||
| |||
