# Late Inguinal Swelling: Don’t Judge a Book by Its Cover! An Unusual Case of Lymphocele

## TL;DR

A man developed an unusual lymphocele in his groin after a cardiac procedure, highlighting the importance of accurate diagnosis in post-surgical swelling.

## Contribution

This case report presents a rare and unusual diagnosis of lymphocele following vascular access procedures.

## Key findings

- A 58-year-old man developed a painful inguinal swelling 45 days after a cardiac procedure.
- The swelling was diagnosed as a lymphocele, an uncommon complication of vascular access procedures.
- The case emphasizes the need for careful differential diagnosis in post-procedural groin swellings.

## Abstract

A 58-year-old man with a history of diabetes type I and chronic coronary syndrome who underwent coronary artery bypass grafting (CABG) 7 years before was admitted to a cardiology unit for unplanned cardiac catheterization because of dyspnea and chest pain at rest. Femoral access was chosen because of the previous CABG and a vascular closure device (VCD) was used at the end of the procedure. Because of femoral artery rupture during VCD implantation, surgical vascular repair was performed. About 45 days later, the patient experienced a growing inguinal swelling at the site of vascular access in the absence of fever and clinical features of inflammation. The swelling became painful over time. Despite the most probable hypothesis of a hematoma, pseudoaneurysm, and inguinal abscess, a final diagnosis of lymphocele was made.