経皮的リンパ管硬化療法が有効であった下肢リンパ浮腫を伴う乳糜尿症の1例

Abstract

乳糜尿症及び左下肢浮腫がある45歳女で, 31歳時に帝王切開及び子宮摘出術を受けてから左下肢浮腫が出現した.ミクロフィラリアは検出されないので術後リンパ管腫症と診断された.腎盂内0.1～0.5%硝酸銀注入は無効であった.左鼠径リンパ節のdoxycyclineによる硬化療法後, 乳糜尿症は消失し, 左下肢浮腫は改善した.その後, 左下腿の余剰皮膚を切除した

A 45-year-old woman with left leg edema was admitted to our hospital because of chyluria from the previous year. Her left leg edema appeared after Caesarean section for her first delivery and hysterectomy at the age of 31. Because microfilaria was not detected, she was diagnosed with postoperative lymphangiomatosis. The instillation of 0.1-0.5% silver nitrate into the renal pelvis was not effective. We however, after percutaneous sclerotherapy to the left inguinal lymph nodes with doxycycline, the chyluria disappeared and her left leg edema improved. Then, the surplus skin of her left lower leg was resected. We considered percutaneous sclerotherapy to be a good procedure for chyluria due to postoperative lymphangiomatosis.