PMC9994301_01
Sonographic images demonstrating a large hypoechoic collection (lymphocele) compressing the ureter and leading to hydronephrosis. Note the relationship between the lymphocele, renal collecting system, and the urinary bladder. RLQ = right lower quadrant; LY = lymphocele; C = renal collecting system; HY = hydronephrosis; BL = urinary bladder.
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A bedside renal sonogram demonstrated moderate hydronephrosis of the renal allograft secondary to compression of the transplanted ureter by a large anechoic fluid collection in the pelvis (Figure 1).
Computed tomography (CT) scan of the abdomen and pelvis without contrast demonstrating a large lymphocele occupying most of the pelvis. Arrows point to dilated renal collecting system/hydronephrosis.
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Computed tomography (CT) scan confirmed the same (Figure 2) and the patient underwent ultrasoundguided drainage of approximately 450 cc fluid the next day with drain placement leading to improvement in urine output.
Repeat sonogram after the intervention demonstrating significant improvement in hydronephrosis and lymphocele.
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Laboratory analysis of the fluid was consistent with lymphocele and a repeat sonogram showed significant improvement (Figure 3).