COMBINATION OF PREOPERATIVE LYMPHANGIOGRAPHY USING LIPIODOL AND INTRAOPERATIVE LYMPHANGIOGRAPHY USING EVANS BLUE FACILITATES THE ACCURATE IDENTIFICATION OF POSTOPERATIVE CHYLOUS FISTULAS

In a 61-year-old woman who underwent extensive retroperitoneal lymph n ode dissection for rectal cancer, postoperative chylous ascites develo ped. The site of the lymphatic leak was evident on the lymphangiogram with lipiodol taken prior to the surgical repair of the leak, and anot her site seen on the intraoperative lymphangiogram using Evans Blue. A direct surgical repair led to good results. Therefore, the combinatio n of pre- and intraoperative lymphangiography facilitates the successf ul surgical management of rare but alarmingly dangerous postoperative chylous ascites.