Interventional therapy of refractory lymphatic ascites post pelvic lymphadenectomy: a case report and literature review

Lymphatic ascites is an infrequent but severe complication that can occur after lymphadenectomy in a patient who had gynecologic malignancies. Without appropriate management, lymphatic ascites can induce electrolyte disorder, hypoproteinemia, immunologic dysfunction, and even life-threatening. However, the optimal management is still unknown. We report a case with successful management of refractory pelvic lymphatic ascites in a patient with cervical cancer status post laparoscopic radical hysterectomy and pelvic lymph node dissection (PLND). Ultrasound-guided intranodal lymphangiography (UGILG), an innovative procedure, was used, and a leakage point at the left iliac fossa was identified after unsuccessful conservative treatments. Leakage of lymphatic fluid was treated successfully by embolizing the defect area under the guide of UGILG. UGILG is a feasible and alternative procedure for the diagnosis and treatment of lymphatic ascites, especially in women with a complicated gynecological procedure.yyy