ArticleBJR case reports2026
Dual-target lymphatic embolization for refractory chylous ascites after nephroureterectomy.
Article in BJR case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
We report a case of refractory chylous ascites following nephroureterectomy and para-aortic lymphadenectomy for renal pelvic carcinoma, which was successfully treated with percutaneous lymphatic embolization. An 83-year-old man underwent nephroureterectomy with para-aortic lymph node dissection for renal pelvic carcinoma. Postoperatively, >1000 mL/day of chylous ascites was continuously drained. Despite conservative management, high-output ascites persisted. Transnodal lymphangiography via the inguinal lymph nodes and post-lymphangiographic CT revealed lymphatic leakage at the nephroureterectomy site. Percutaneous lymphatic embolization was planned as a minimally invasive procedure. Under CT guidance, embolization of a lymphopseudoaneurysm and para-aortic lymph nodes near the leakage site was successfully performed using N-butyl cyanoacrylate. Ascitic fluid output decreased significantly postoperatively, and the drainage tube was removed the following day. This case highlights the importance of post-lymphangiographic CT in identifying actionable lymphatic targets and demonstrates that an anatomically tailored dual-target embolization strategy can achieve effective sealing when central duct access is not feasible.
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