POSTTRANSPLANT LYMPHOCELE PRESENTING AS ACUTE ABDOMEN

Lymphoceles occurring after renal transplantation are frequently asymp tomatic and are usually identified on routine ultrasonogrpahy of the a llograft. A small percentage of them may increase in size and manifest due to their compression effects on adjacent structures or as lymphoc utaneous fistula. An infected lymphocele would, in addition, give rise to local and systemic features. A case of infected lymphocele occurri ng 4.5 months after cadaveric renal transplant is reported. The patien t presented in septicemia and features of generalized peritonitis. Eme rgency diagnostic laparoscopy revealed fluid collection in the periton eal cavity. However, on exploratory laparotomy no intra-abdominal path ology was detected. Further evaluation revealed a large perigraft lymp h collection which was drained percutaneously. Fluid and blood culture s grew Staphylococcus aureus. The patient recovered completely followi ng external drainage and antibiotic administration.