The lymphatic system in vertebrates consists of a network of clear fluid that flows all through the body. This fluid is known as lymph. Lymph travels through lymphatic channels that flow all through the body. It is formed when interstitial fluid enters the initial lymphatic system. However, when there is formation of an abnormal sac or cyst, containing lymphatic fluid, which has entered from either a diseased or injured lymphatic channel, then it is known as a lymphocele. Though many lymphoceles are asymptomatic, the larger ones can cause symptoms like constipation, pain in lower abdomen, edema in genitals, etc. However, these symptoms will vary depending on the location of the lymphocele.
How Does a Lymphocele Form?
Lymphoceles often occurs as a result of a complication after a surgical procedure. This is seen if the surgical procedure involved a very large area in which a lot of lymphatic tissues were involved. Due to this, if there is any kind of injury to the lymphatic vessel, there is leakage of lymph, which leads to formation of swellings that contain lymph. Thus, lymphoceles normally occur due to injury to the lymphatic vessels during surgery. However, there can be many differential diagnoses of a swelling which occurs after a postoperative surgical procedure. These include urinoma, hematoma, seroma, or an abscess.
Due to Renal Transplant
A renal transplant is a major surgery that requires extensive preoperative and postoperative care. It is important to deal on an emergency basis with a lymphocele. Renal transplant is a major surgery where one cannot take a risk of leaving a lymphocele in place, as this increases the chances of organ rejection, or may even hamper the functioning of the new kidney.
After Radical Hysterectomy
It is commonly seen that a lymphocele develops after a radical hysterectomy which is normally done after a patient is diagnosed with aggressive uterine cancer, due to which the entire uterus needs to be removed. In fact, quite often, the doctors prefer to take preventive measures, like placing a drain, so as to decrease the possibility of any such complications.
After Thoracic Surgery
There have been cases where a lymphocele has been developed in the mediastinum, following a thoracic duct injury, which may have been iatrogenic in nature or due to a blunt trauma in the region.
Certain other surgeries can also lead to complications; for instance, pelvic and aortic lymphadenectomy accounts for more than around 50% of iatrogenic injuries. One of the most common postoperative complications of a lymophadenectomy procedure is lymphocele. A lymphocele after a blunt injury to the thigh is relatively rare and may occur either after a pelvic surgery or due to crushing injury of the thigh or pelvic region. Pelvic lymphocele may occur due to blunt trauma from a motor vehicle collision as well, where there has not been any fracture to the bones.
More often than not, the surgeons leave a drain in place which helps to get rid of the collected fluid. This is the standard protocol for treatment. However, there are cases where the drainage does not take place completely, due to which the person may even require surgical intervention to help drain the lymphocele. Thus, it is important to always try to avoid a complication like a lymphocele after a surgical procedure, but if symptoms do show up, then it is best to deal with this condition on an emergency basis.