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[Intraabdominal cystic lesions - the differentation of mesenteric cysts and cystic lymphangioma].

Mesenteric cysts and cystic lymphangioma are rare intraabdominal lesions. In our clinic, during one year, two young women with these intraabdominal cysts underwent operation because of unspecific abdominal pain. Despite preoperative imaging the final diagnosis of a cystic lymphangioma and a mesenteric chylous cyst was made not before surgery. The postoperative course was uneventful. Problems of diagnostic, differential diagnosis and therapy are presented and differences in etiology, histology and location are discussed.

Adult↗

Chylopericardium following aorto-coronary bypass-procedure.

The complication of chylopericardium following cardiac surgery is extremely rare. We report such a patient who had undergone a coronary artery bypass operation. The cause of chylopericardium in this patient appears to have been intraoperative injury to the tributaries of the thoracic duct. A conservative regimen with continuous drainage and a special diet containing medium chain triglycerides was all that was necessary for the management of this complication.

Chyle↗

[The diagnosis of lymphatic vascular dysplasia and lymphatic fistula formation].

The importance of lymphangiography for diagnosing the formation of lymphatic fistulas and vascular dysplasias of the lymphatic vessels is on the increase within the scope of therapeutic invasiveness. Its importance and ranking in diagnosing lymphatic circular disorders is demonstrated and exemplified by case reports on three patients suffering from chylothorax of various origin, on one patient with chyluria, and one patient with lymphoedema in the soft parts of the neck. In two chylothorax patients, lymphangiography resulted in successful surgery. It is the decisive method in diagnosis and therapy planning in fistulas and dysplasias of the lymphatic vessel system.

Adult↗

[Chylous lymphocele: a rare complication after gastrectomy for primary non-Hodgkin's lymphoma of the stomach].

Gastrectomy and extensive lymphatic resection were performed in a 55-year-old woman with primary non-Hodgkin lymphoma of the stomach. Three months later a large perihepatic lymphocele developed. After placement of a catheter under ultrasound control and evacuation of about 5.31 of chylous fluid there was no recurrence or further sequelae. This complication is so rare that it should not be a reason for limited lymphatic resection in malignant disease.

Chyle↗

[Chylaskos in lymphangioleiomyomatosis. Peritoneo-venous drainage with Denver shunt].

Chylous ascites, due to a lymphangiomyomatosis and resistant to conservative therapy, occurred in a 30 year-old female. A distinct subjective and clinical improvement could be attained with the aid of a peritoneo-venous anastomosis employing a Denver-Shunt. With the preconditions that the implantation is correct and that it is reliably managed, we regard the Denver-Shunt system as a recommendable approach to the treatment of chylous ascites not controllable by conservative measures.

Adult↗

[Diagnosis and treatment of chylopericardium (author's transl)].

In a 22-year-old patient without clinical symptoms, a chylous pericardial effusion was found as cause of pericardial enlargement persisting over 7 years. Ultrasonic echocardiography, diagnostic pericardial puncture and the demonstration of chylomicrons enabled the diagnosis to be made. Lymphography showed lymphangiectasis of the thoracic duct. At operation two fistulous connections between pericardium and lymphatic system were found. Surgical ligature of the thoracic duct and the lymphatic fistulae and pericardial fenestration resulted in rapid normalisation of all findings.

Adult↗