Symptomatic lymphocele after kidney transplantation a single-center experience

In a retrospective study, we evaluated the frequency, clinical presentation, and management of lymphocele in kidney transplant recipients operated on in a single center. Between September 1984 and June 2005, we had 2147 kidney transplantations from living donors. During the follow-up period, ultrasonography was performed in symptomatic patients and those with elevated serum creatinine level postoperatively. Other radiological procedures were done in complicated cases. Patients with lymphocele were treated by percutaneous drainage with or without injection of sclerotizing agent [povidone iodine]. If recurrence occurred, surgical intraperitoneal drainage was performed. In cases with multiloculated collection or inappropriate access for percutaneous drainage, the primary approach was surgical intraperitoneal drainage. Symptomatic lymphocele collection was seen in 17 kidney recipients of our series [0.8%; 95% confidence interval, 0.4% to 1.2%]. It presented with elevation of serum creatinine concentrations [47.1%], pain and abdominopelvic swelling [29.4%], and lower extremity edema [23.5%]. Percutaneous drainage was used for the treatment of lymphocele in 11 patients, but recurrence occurred in 7 [63.6%]. These cases were treated with open surgical drainage. In 6 patients, the primary approach was surgical intraperitoneal drainage, because of multiloculated collection or inappropriate access for percutaneous drainage. All of the patients were treated successfully and no graft loss occurred during the follow-up period. Symptomatic lymphocele is an uncommon complication after kidney transplantation. Surgical intraperitoneal drainage is the most effective approach for the management of symptomatic lymphocele

Linfocele como complicación del trasplante renal / Lymphocoele as complication of the renal transplantation

Se presenta una revisión retrospectiva de la incidencia y el manejo del linfocele en 293 trasplantes renales realizados en pacientes con insuficiencia renal crónica en el Hospital del Salvador, desde 1975 hasta junio de 1996. Se produjo linfocele como complicación postoperatoria en 9 pacientes (3.1 por ciento), siendo sospechado el diagnóstico por el cuadro clínico y confirmado por estudio de ultrasonido. El tratamiento par esta complicación fue: punción dirigida por ecografía en 3 casos, drenaje a cielo abierto en 2 y marsupialización laparoscópica en 4. Con las dos modalidades quirúrgicas tuvimos recurrencia que requirió reintervención, resolviéndose el problema en segunda instancia. No tuvimos complicaciones ni mortalidad derivadas de los procedimientos efectuados. Tenemos 8 (96 por ciento) pacientes con su injerto funcionante

Benign cystic lymphoepithelial lesion of the parotid gland an unusual presentation of the acquired immunodeficiency syndrome

This article presents a case of a young, otherwise asymptomatic male patient with a parotid gland enlargement. The initial clinical history did not reveal any risk factors related with HIV infection. A fine needle aspiration biopsy of the lesion showed a benign cystic lymphoepithelial lesion of the parotid gland. This once unusual lesion of the salivary gland has been recently associated with infection by the human immunodeficiency virus (HIV) and is presently encountered with increased frequency in the clinical practice. The knowledge of the association between these two entities led, in this case, to the diagnosis of HIV infection in an otherwise asymptomatic patient. Early detection of HIV infection is of vital importance since it has been demonstrated that prompt treatment of these patients with AZT slows down the progression of the disease

Intra-abdominal lymphatic cysts in children.

Ten children with intra abdominal lymphatic cysts operated in the last 8 years are reported. They formed 0.50% of all pediatric surgical admissions and 33.3% of all intra-abdominal cystic lesions. The mean age was 5 1/2 years and the male-female ratio was 1:1. Half the cysts were in the mesentery and 30% in the omentum. The other 2 cysts were located at unusual sites. Two children having mesenteric cysts presented as abdominal emergencies. Three of them were wrongly diagnosed and treated for tuberculous ascites before laparotomy. Four mesenteric cysts were excised along with the adjoining intestinal segment, and one was drained by tube marsupialisation. All 3 omental cysts and the two cysts at unusual sites were excised in toto. There was no mortality or morbidity.