PMC9377309_01
Ultrasonography demonstrating inguinal lymph nodes of a habitual size
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Initially, an ultrasound-guided puncture of the lymph node near the fistula site was performed (Figure 1), allowing the injection of lipiodol (Figure 2) and the consequent mapping of the lymphatic system (Figure 3).
Pelvic radioscopy showing lymph nodes with enhancement (black circles) after ultrasound-guided puncture and lipiodol infusion
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Initially, an ultrasound-guided puncture of the lymph node near the fistula site was performed (Figure 1), allowing the injection of lipiodol (Figure 2) and the consequent mapping of the lymphatic system (Figure 3).
Small lymphatic vessels (black arrows) carrying the contrast to the deep pelvic basins
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Initially, an ultrasound-guided puncture of the lymph node near the fistula site was performed (Figure 1), allowing the injection of lipiodol (Figure 2) and the consequent mapping of the lymphatic system (Figure 3).
Leakage of the contrast into the lymphocele cavity (black arrows)
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This showed contrast medium leakage and identified the fistulous tract (Figure 4).
Lipiodol being aspirated through the previously allocated percutaneous drain (black arrows)
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The intraprocedural control showed good diffusion of the solution through the lymphatic system, with obstruction of the fistula site (Figure 5).