Diagnostics and features of endovideosurgical treatment of posttraumatic lymphocele
B. V. Sigua , V. P. Zemlyanoy , D. V. Gurzhiy , A. S. Kachiuri , V. A. Melnikov , S. A. Vinnichuk
Bulletin of the Russian Military Medical Academy ›› 2019, Vol. 21 ›› Issue (3) : 26 -29.
Diagnostics and features of endovideosurgical treatment of posttraumatic lymphocele
Such a disease as lymphocele can’t be called widespread in the population, and therefore the incidence of this topic, both in the domestic and in foreign literature is rather scarce. In addition, from several sources studied by us, not a single one speaks of the traumatic origin of the lymphocele. Thus, we can talk about the originality of the described clinical case. In addition to a brief overview of this problem, an example of successful endovideosurgical treatment of a patient with post-traumatic lymphocele of the small intestine mesentery root is given. The patient was admitted to the clinic of faculty surgery named after I.I. Grekov North-Western State Medical University named after I.I. Mechnikov with complaints of abdominal pain, arising mainly in the sitting position, not related to eating and defecation. According to the ultrasound of the abdominal cavity on the left in the mesogastrium, at the level of the navel, between the intestinal loops, an avascular hypoechoic rounded formation with a clear even contour, with a hyperechoic capsule, is measured, measuring 65×67×70 mm. According to the multislice computed tomography of the abdominal cavity in the left flank at the level of L2–L3 in the interhelium space, a rounded cyst-like formation of fat density with clear even contours, intimately adjacent to the wall of the small intestine, with a thick capsule from 4 mm to 7 mm thick, with overall dimensions is determined 66×64×68 mm, along the inner contour of the capsule, single flat calcined inclusions are detected. The diagnosis at admission – cyst of the mesentery of the small intestine. The patient underwent surgery in the volume of laparoscopic removal of a cyst of the mesentery root of the small intestine. The postoperative period was complicated by lymphorrhea. Thus, taking into account the data of anamnesis, clinical picture, laboratory and instrumental studies, intraoperative picture and histopathological conclusion, the final diagnosis is post-traumatic lymphocele of the mesentery root of the small intestine. The patient was discharged on the 21st day of the postoperative period in a satisfactory condition under the outpatient supervision of a surgeon of a polyclinic at the place of residence.
surgery / laparoscopy / lymphocele / lymphorrhea / cyst / mesentery / intestine / lymphostasis
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Sigua B.V., Zemlyanoy V.P., Gurzhiy D.V., Kachiuri A.S., Melnikov V.A., Vinnichuk S.A.
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