PMC8277509_01
Ultrasonography performed during intranodal lymphangiography demonstrating a 23-gauge needle (arrow) being advanced into an inguinal lymph node (arrowhead).
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Under local anesthesia, bilateral inguinal lymph nodes were punctured with a 23-gauge cathelin needle under ultrasound guidance (Figure 1).
Pelvic X-ray performed during intranodal lymphangiography demonstrating leakage of lipiodol (arrows) from the left wall of the pelvis into the peritoneal cavity.
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Lymphatic leakage from the left pelvic wall into the peritoneal cavity was detected (Figure 2).
Laparoscopic image taken during surgical repair of lymphorrhea demonstrating droplets of lipiodol (white arrows) flowing out from a dent (white arrowhead) on the left wall of the pelvis; surgical clips (black arrows) that were placed during cystectomy to prevent lymphatic leakage and the left external iliac artery (black arrowhead) can be observed.
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Three minutes after administering lipiodol injection, laparoscopy revealed extravasation of lipiodol and indigo carmine from the dent (Figures 3 and 4 and Supplementary Video).
Laparoscopic image taken during surgical repair of lymphorrhea demonstrating indigo carmine (arrowhead) flowing out from a dent on the left wall of the pelvis.
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Three minutes after administering lipiodol injection, laparoscopy revealed extravasation of lipiodol and indigo carmine from the dent (Figures 3 and 4 and Supplementary Video).