Abstract
An 80-year-old woman had undergone anterior resection for a circumferential type 2 tumor located 15 cm from the anal margin. A large amount of chylous discharge was observed from the first postoperative day. She was diagnosed with lymphorrhea, which was improved by a low-fat diet and diuretic administration. She was discharged on the 23rd postoperative day. However, lymphorrhea recurred 1 month after surgery, which was persistent even after administration of octreotide and diuretics and ascites puncture. Lymphangiography using lipiodol was performed by puncturing the bilateral inguinal lymph node as a diagnostic treatment on the 112th postoperative day, and contrast agent leakage was observed from the outer aortic lymph node. A marked decrease in ascites was achieved on the 151st postoperative day, and no recurrence was observed for 3 years without retention of ascites.
Surgical treatment is recommended for refractory lymphorrhea after gastrointestinal surgery ; however, the success rate remains low. Therapeutic lymphangiography using lipiodol can be a useful therapeutic option against intractable lymphorrhea after gastrointestinal surgery.
