Zusammenfassung
Die laparoskopische Lymphozelenfensterung stellt eine Standardtherapie bei symptomatischen Lymphozelen nach Nierentransplantation dar. Wir berichten über eine Patientin, die nach erfolgter Nierentransplantation eine symptomatische Lymphozele entwickelte. Nach laparoskopischer Lymphozelenfensterung kam es einige Wochen später zu einer Ileussymptomatik. Eine computertomographische (CT-)Untersuchung zeigte eine inkarzerierte Dünndarmhernie in das zu kleine iatrogene Peritonealfenster. Es handelt sich um eine seltene Komplikation nach Lymphozelenfensterung. Durch CT-gestützte Bildgebung und zügige operative Revision mit Erweiterung des peritonealen Fensters lassen sich schwerwiegende Komplikationen vermeiden.
Abstract
Laparoscopic lymphocele drainage is considered the gold standard for the treatment of lymphoceles after kidney transplantation. We report on a female patient who developed a symptomatic posttransplant lymphocele. After laparoscopic lymphocele drainage the patient presented with acute pain in the left lower abdomen. A CT scan showed a hernia into the peritoneal window. This is a rare but potentially severe complication after intraperitoneal lymphocele drainage. CT imaging and swift reoperation with enlargement of the peritoneal window are critical to avoid serious complications. To avoid bowel incarceration, the peritoneal window should be as large as possible.
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Friedersdorff, F., Roller, C., Baumunk, D. et al. Inkarzerierte Hernie nach laparoskopischer Lymphozelenfensterung. Urologe 49, 1169–1171 (2010). https://doi.org/10.1007/s00120-010-2323-7
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DOI: https://doi.org/10.1007/s00120-010-2323-7