Omentoplasty for Cervical Lymphocele after Aortic Arch Replacement

TL;DR

A 53-year-old man had recurring cervical swelling after aortic surgery, which was treated successfully with omentoplasty and fibrin glue.

Contribution

The paper presents a successful surgical approach using omentoplasty for a rare complication after aortic arch replacement.

Findings

Recurring cervical swelling was diagnosed as a lymphocele after two thoracic aortic surgeries.

Application of fibrin glue and omental flap led to complete regression of the swelling.

The surgical intervention provided a long-term solution without infection or recurrence.

Abstract

Lymphocele formation is a rare complication after surgical procedures involving the mediastinum. While uncomplicated lymphoceles show high rates of spontaneous closure and are usually treated conservatively, surgical treatment might be required in cases with persistent or recurrent lymphoceles. We present the case of a 53-year-old male with reoccurring cervical swelling after two surgeries of the thoracic aorta. After 1.5 years, the swelling occurred for the first time and appeared for the next 2 years repeatedly without clinical or laboratory signs of infection. A cervical lymphocele was suspected, and the decision for surgical revision was made. Fibrin glue was applied to the potential leakage of the thoracic duct, and the cavity was filled with a free omental flap. This resulted in a complete regression of the swelling.

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