We report the case of a 69-year-old woman with a history of hypertension and hypercholesterolemia, with end stage renal disease of unknown etiology, with nephrogenic anemia treated with stimulating factors of secondary erythropoiesis and hyperparathyroidism.
Residual diuresis was around 200 mL per day.
In the year 2004 he started a sustitutive treatment of renal function by hemodialysis, later entering the waiting list of renal transplantation.
The patient received a renal transplant from a cadaveric donor in the right iliac fossa in January 2008.
The postoperative period is correct except for two medical complications: development of diabetes mellitus requiring insulin administration and toxicity by anticalcineurinics, which means that initially the graft is not functioning.
She was discharged in the fifth week after surgery with creatinine of 0.9 mg/dl and diuresis of approximately 2000 ml/day, receiving triple therapy with prednisone, tacrolimus and mycophenolate mofetil.
The patient was readmitted two weeks later due to a picture consisting of significant edema in the right lower limb and deterioration of renal function, with decreased diuresis and increased plasma creatinine concentration up to 2 mg/dl. The patient had a good overall fever.
The ECHO shows a large peri-injection collection, subsequently studied with CAT, which extends from a somewhat more cranial level than the aortic bifurcation to the rectum, producing compression of the iliac bladder vessels.
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Percutaneous puncture and placement of pigtail to drain the collection is followed by a great improvement of symptoms and biochemical analysis of the fluid obtained (creatinine 1.67 mg/dl, lymphocele 4.3 mEq/l, clinical suspicion of lymphocele
Surgical treatment is indicated, carrying out, once the infection is ruled out, marsupialization of the lymphocele to peritoneal cavity laparoscopically.
The patient was discharged on the third postoperative day with normal and asymptomatic renal function.
A follow-up CT scan at 14 days showed resolution of the lymphocele.
