Laparoscopic Assisted Sclerotherapy for Retroperitoneal Lymphatic Malformation

P Mandhan, A Hobson, M Krauss, S Beasley, K Maoate, J Wells

Canterbury District Health Board, Christchurch, New Zealand, University of Otago, Christchurch, New Zealand

Introduction

Retroperitoneal Lymphatic Malformation (RLM) is a rare cause of abdominal pain in the paediatric population. We describe the management of this case and review the literature.

Case Presentation

A four-year-old boy presented to our institution with recurrent abdominal pain, initially diagnosed as constipation. A plain radiograph showed a paucity of gas in the central and lower abdomen and ultrasound confirmed the presence of a fluid-filled cystic structure. Magnetic resonance imaging further delineated this as most likely an RLM with evidence of recent intra-lesion haemorrhage. The diagnosis was confirmed laparoscopically and the RLM drained percutaneously and sclerosed with OK432. He is currently asymptomatic and under clinical follow-up.

Conclusion

RLM are rare and the diagnosis and management can be challenging. Several centres describe using image-guided drainage of RLM. This case highlights the use of laparoscopy to confirm the diagnosis and guide successfully drainage and sclerotherapy.

Keywords:

Laparoscopic Assisted Sclerotherapy for Retroperitoneal Lymphatic Malformation

P Mandhan, A Hobson, M Krauss, S Beasley, K Maoate, J Wells

Canterbury District Health Board, Christchurch, New Zealand, University of Otago, Christchurch, New Zealand

Introduction

Retroperitoneal Lymphatic Malformation (RLM) is a rare cause of abdominal pain in the paediatric population. We describe the management of this case and review the literature.

Case Presentation

A four-year-old boy presented to our institution with recurrent abdominal pain, initially diagnosed as constipation. A plain radiograph showed a paucity of gas in the central and lower abdomen and ultrasound confirmed the presence of a fluid-filled cystic structure. Magnetic resonance imaging further delineated this as most likely an RLM with evidence of recent intra-lesion haemorrhage. The diagnosis was confirmed laparoscopically and the RLM drained percutaneously and sclerosed with OK432. He is currently asymptomatic and under clinical follow-up.

Conclusion

RLM are rare and the diagnosis and management can be challenging. Several centres describe using image-guided drainage of RLM. This case highlights the use of laparoscopy to confirm the diagnosis and guide successfully drainage and sclerotherapy.

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