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Abdominal pain: The black box. Retrospective evaluation of patients administered to the emergency department due to complicated lymphocyt

机译:腹痛:黑匣子。对复杂淋巴细胞导致急诊患者的回顾性评估

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摘要

Lymphocyst is mainly observed following extraperitoneal surgery. In this retrospective study, we aimed to determine the results of patients treated with percutaneous catheter drainage who referred to the emergency department due to lymphocyst complications. The examined group was consisted of 17 patients. All patients admitted to the emergency were suffering from abdominal pain. Ultrasonography (USG) was performed to all patients. Computerized tomography (CT) and magnetic resonance ?maging (MRI) were performed in 13 and 1 patient respectively. With the imaging evaluation complicated lymphocysts were detected. In 5 cases compression of urinary bladder, in 5 cases hydroureteronephrosis, in 2 cases compression of the left external iliac vein, in 1 case compression of the small and large intestine were observed. Percutaneous catheter drainage and sclerotherapy under ultrasonography and fluoroscopy guildance was performed to all cases in interventional radiology unit. To the best of our knowledge most of the lymphocysts were asymptomatic.Complicated lymphocysts may present as acute abdominal pain due to intraabdominal mass effect in patients having undergone surgery for gynecologic malignancy. If the lymphocyst is infected or becomes symptomatic due to compression of adjacent organ must be diagnosed and treated in early period. Clinical and radiological examinations are the key to the diagnosis of complicated lymphocyst. Emergency physicians should consider percutaneus catheter drainage as a treatment of choice.  
机译:淋巴囊肿主要在腹膜外手术后观察到。在这项回顾性研究中,我们旨在确定经皮导管引流治疗的患者因淋巴囊肿并发症而转诊至急诊科的结果。检查组由17名患者组成。接受急诊的所有患者均患有腹痛。对所有患者进行超声检查。分别对13例和1例患者进行了计算机断层扫描(CT)和磁共振成像(MRI)。通过影像学评估发现了复杂的淋巴囊肿。观察到膀胱受压5例,输尿管肾盂积水5例,外左静脉受压2例,小肠和大肠受压1例。在介入放射科对所有病例进行超声检查和透视检查下经皮导管引流和硬化治疗。据我们所知,大多数淋巴囊是无症状的。在接受妇科恶性肿瘤手术的患者中,由于腹腔内质量效应,复杂的淋巴囊可表现为急性腹痛。如果淋巴囊被感染或由于相邻器官受压而出现症状,则必须尽早进行诊断和治疗。临床和放射学检查是诊断复杂淋巴囊肿的关键。急诊医师应考虑经皮穿刺置管引流为首选治疗方法。  

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