Transnodal lymphangiography in the diagnosis and treatment of genital lymphedema
| Autor: | I. Forner, Luis Martí-Bonmatí, M. Lloret, Ernesto Santos, F. M. Gómez, J. Martínez-Rodrigo, R. García-Marcos, D. Pérez-Enguix |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Fistula Punctures Diagnosis Differential Ethiodized Oil Scrotum medicine Humans Radiology Nuclear Medicine and imaging Lymphedema Child Lymph node Ultrasonography Interventional Aged Groin business.industry Lymphography medicine.disease Surgery body regions medicine.anatomical_structure Lymphangitis Fluoroscopy Lipiodol Abdomen Female Radiology Genital Diseases Male Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Genital Diseases Female medicine.drug |
| Zdroj: | Cardiovascular and interventional radiology. 35(6) |
| ISSN: | 1432-086X |
| Popis: | To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4–8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography. |
| Databáze: | OpenAIRE |
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