Fact-sheet: Abdominal seroma
Updated on 09/17/2021 at 12:16 PM
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Definition
Collection of lymph in a cavity not lined by an epithelium. Often seen postoperatively after surgery sacrificing large amounts of lymphatic tissue. Since lymph contains no platelets and few coagulation factors, there is no spontaneous lymphostasis. Etiologies: In the retroperitoneum, it develops mainly after: - lymphadenectomy (prostate, bladder, uterine, rectal cancer) - renal surgery - renal transplantation (in 5 to 15%): 1 year after transplantation. Predisposing factors: incomplete ligation of pelvic lymphatic vessels, prior episode of severe acute rejection. Differential diagnosis: urinoma! - aortic surgery - post-traumatic Complications: - Most often asymptomatic. - Symptoms may be secondary to compression of adjacent structures (pain, hydronephrosis, renal failure, lower limb edema from caval compression, etc.) - Superinfection
CT
Well-defined mass of fluid density, sometimes with a fatty component that is highly suggestive of the presence of lymph. Calcifications may be present but are exceptional.
Management
Treatment of lymphocele:
- "Marsupialization": communication with the abdominal cavity where lymph is physiologically absorbed by the peritoneum.
- Aspiration drainage (risk of recurrence)