A Case of Refractory Lymphorrhea after Sigmoid Colon Resection Cured following Lymphangiography

Abstract

It is believed that postoperative lymphorrhea improves with fasting in many cases, however, there are some cases of lymphorrhea that resists against conservative treatment. We have experienced a case of postoperative refractory lymphorrhea in which lymphangiography appeared to be effective. The case involved an 82-year-old man who underwent laparoscopic sigmoidectomy for sigmoid colon cancer and was discharged after an uneventful postoperative course. On the 36^th postoperative day, he developed abdominal distension. Following close exploration, postoperative lymphorrhea was diagnosed. Since conservative therapy was ineffective, lymphangiography was performed as a preoperative examination to localize the site from where lymphatic fluid leaked. It revealed leakage of contrast material into the abdominal cavity, so that the leakage site appeared to be near the root of the inferior mesenteric artery. After lymphangiography, however, acites decreased in volume spontaneously. Even after regaining of oral ingestion, the patient had no recurrence, and the conservative therapy could be sustained. We present a case of refractory lymphorrhea in which a possibility of lymphangiography as a useful diagnostic therapy has been suggested.