Duodenal stenosis due to small lymphocele after para-aortic lymphadenectomy: A case report and review of the literature.

Takashi Murakami, Yuji Tanaka, Akimasa Takahashi, Tsukuru Amano, Hiroki Nishimura, Shunichiro Tsuji

Journal: Taiwanese journal of obstetrics & gynecology 2024;63(5):741-744

PMID: 39266157

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Abstract

OBJECTIVE

We present an unusual case of a small para-aortic lymphocele causing duodenal stenosis after lymphadenectomy and discuss its treatment.

CASE REPORT

Our case involved a 57-year-old woman with endometrial cancer who underwent surgery, including para-aortic lymphadenectomy. On postoperative day 7, projectile vomiting occurred. Computed tomography (CT) revealed a small lymphocele in the dorsal duodenum, causing duodenal stenosis. Transpercutaneous and transduodenal puncture or surgical procedures were difficult because the cyst was too small. Per endoscopic and gastrointestinal series findings on the postoperative day 22, a liquid diet was presumed to be able to pass through the narrow portion. Hence, concentrated liquid food was administered orally; no vomiting occurred. At 2 months postoperatively, CT showed no lymphocele.

CONCLUSION

Conservative treatment involving waiting for spontaneous lymphocele reduction with a concentrated fluid diet may be considered in such cases if fluid passage is confirmed with endoscopy and gastrointestinal series.

Address: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Japan. Electronic address: [email protected].

DOI: 10.1016/j.tjog.2024.04.017

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MeSH Terms: Humans, Female, Lymphocele, Middle Aged, Lymph Node Excision, Endometrial Neoplasms, Duodenal Obstruction, Tomography, X-Ray Computed, Postoperative Complications, Constriction, Pathologic