Symptoms Of Lymphocele: What Are Its Causes & Treatment Options?

Lymphocele is an abnormal accumulation of lymphatic fluid in some part of body. The sac or cavity in which the lymph fluid gets collected is devoid of epithelial lining therefore it is not considered as a cyst. In humans, similar to blood vessels there is another system called lymphatic channel. A clear fluid called lymph circulates through the system.

At certain points there are lymphatic ducts. Lymph fluid drains from the tissues into the duct and circulates in the lymphatic system.

Damage or injury to lymphatic channel results in leakage of clear lymph. It collects into a cavity or a sac. This collection of lymph is called lymphocele. The size of lymphocele may vary. Smaller lymphocele does not produce any problem, however large sized lymphocele can cause pain and swelling in the area where it has formed.

What Are The Causes Of Lymphocele?

Usually lymphocele develops after a major surgery, where there is always a risk of injuring the lymphatic channel during the procedure. It is one of the surgical complications.

Major surgery of pelvis, lungs, and kidney has risk of developing lymphocele. The condition is often observed after lung surgery or radical hysterectomy.

During the surgery lymph channels and lymph glands can get damaged. The clear lymph fluid leaks from the lymphatic system into the cavity giving rise to lymphocele. It is similar to hematoma formed by collection of blood. Here are some of the major causes for development of lymphocele:

  • Pelvic surgery: Lymphocele often develops after radical hysterectomy. This surgery is performed to remove uterus. Various reasons such as a large fibroid, ovarian cancer etc are indication of hysterectomy. Similarly it can also develop after prostate removal in males.
  • Thoracic surgery: Surgery of lungs and mediastinal organs can lead to formation of lymphocele. The chest cavity contains large number of lymphatic channel. There is possibility of damage to the lymphatic channel during the surgical procedure.
  • Kidney transplant: There is high risk of formation of lymphocele after the kidney transplant surgery. Therefore surgeons take precautions to prevent its formation. They insert a drainage line through which blood and lymph fluid can be drained out. Large lymphocele can increase the risk of organ rejection.
  • Lymphadenectomy: It is a procedure during surgery where the lymph nodes are removed from certain area. It is common during surgery of a cancerous organ. For example during breast cancer surgery many lymph nodes from axilary area are removed.
  • Severe crush injury can also damage blood vessels and lymphatic channel. Lymphocele and hematoma can develop after a severe crush injury such as a car accident etc.

Signs And Symptoms Of Lymphocele

Lymphocele itself is a complication usually after a major surgical procedure. It develops after a surgery. The size may vary from small to large. Many small lymphocele do not produce any symptoms. However large sized lymphocele is a cause of concern as it may compress the adjacent organs producing pain and swelling.

  • When present in abdomen it can cause bloating, pain in abdomen etc. A large sized lymphocele in lower abdomen can compress the large intestine giving rise to constipation or intestinal obstruction.
  • Lymphocele in pelvis region can irritate the bladder. It may lead to increased frequency of urination. It may also cause genital swelling or swelling in legs due to compression.
  • The skin over lymphocele may become discolored.

Treatment Options For Lymphocele

Lymphocele of a small size which does not produce any symptoms gets absorbed over a period of time. However, a large lymphocele producing symptoms of pain and swelling needs to be investigated and treated. Imaging techniques such as MRI and ultrasound help in diagnosis of the condition.

Usually after a major surgery, doctors insert a drainage tube so that the fluid and blood collected at the operated site drains out. But even after taking all precautions few patients may have risk of developing a lymphocele. In such situation immediate surgical drainage of lymphocele may be necessary.

Delay in treating or drainage of the fluid may hamper healing process at the operated site. A large lymphocele can compress the blood vessels in the area and restrict proper blood flow. Poor blood circulation may hinder in healing of wound. It may also increase the risk of infection.