リンパ管造影により治癒した腎移植後リンパ嚢腫の3例

抄録

A lymphocele after renal transplantation can cause a deterioration in renal function and cause a local infection. We report three cases of post-renal transplant lymphoceles managed successfully by inguinal lymphangiography with Lipiodol^®.

【Case 1】 A man aged in his forties received CT-guided drainage for a lymphocele on the 18th day of kidney transplantation; however, the volume of drainage did not decrease. Inguinal Lipiodol^® lymphangiography was performed 25 days after the transplant; the lymphocele was imaged and resulted in the lymphatic discharge stopping four days later.

【Case 2】 A woman aged in her sixties received CT-guided drainage for a lymphocele on the 50th day of kidney transplantation; however, the volume of drainage did not decrease. Inguinal lymphangiography was performed 62 days after the transplant. Despite most of the injected Lipiodol^® leaking into the adjacent subcutaneous tissue because of the small size of the lymph node, the discharge stopped three days after lymphangiography.

【Case 3】 A man aged in his thirties received CT-guided drainage for a lymphocele on the 12th postoperative day. Because the volume of drainage did not decrease, inguinal lymphangiography was performed on the 19th postoperative day. The lymphatic discharge continued after the first session of Lipiodol lymphangiography and therefore a second session was performed. Lymphatic discharge stopped 6 days after the second session.

No recurrence of lymphocele occurred in any of the three cases. Based on these clinical outcomes, we conclude that Lipiodol^® lymphangiography for lymphocele after renal transplantation is a minimally invasive and effective procedure.