A case of refractory lymphatic fistulas after superficialization of the brachial artery that was successfully treated with a combination of nutritional therapy and invasive procedures

Abstract

Lymphatic fistulas are a rare complication after superficialization of the brachial artery, and there are no established treatment guidelines. We report a case of refractory lymphatic fistulas after superficialization of the brachial artery, which was successfully treated with a combination of nutritional therapy and invasive procedures. A 72-year-old male with short bowel syndrome developed lymphatic fistulas after bilateral superficialization of the brachial artery. Invasive treatment was employed for the left lymphatic fistula, which healed within 174 days. On the other hand, a combination of invasive treatment and nutritional therapy was used for the right lymphatic fistula, which healed within 69 days. Compared with invasive treatment alone, the addition of nutritional therapy shortened the recovery time of a refractory lymphatic fistula in a hypotrophic patient. Appropriate nutritional management may lead to early improvement of refractory lymphatic fistulas after superficialization of the brachial artery in hypotrophic patients.