Lymphatic Injury with Lymph Fistula After Anterior Lumbar Fusion Managed with Vacuum-Assisted Closure: A Case Report

October 21, 2021

doi: 10.2106/JBJS.CC.21.00352.

Affiliations

Item in Clipboard

Davis A Hartnett et al.

JBJS Case Connect.

2021.

Abstract

Case:

A 40-year-old man underwent an L5-S1 anterior lumbar interbody fusion (ALIF) and subsequently developed abdominal distention and persistent wound drainage. During wound reexploration, a substantial lymphocele and lymphatic fistula tracking from the ALIF site were visualized and evacuated. The deep space was coated with fibrin sealant. A deep drain and wound vacuum were placed within the retroperitoneal cavity, leading to progressive recovery.

Conclusion:

Intraoperative lymphatic injury during anterior spinal surgery can progress to the development of a lymphocele and lymphatic fistula, manageable with an exploratory laparotomy, fibrin sealant, and the use of a wound vacuum to promote fistula sealing.

Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B691).

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