Presentation
Abdominal pain and distension following L4-S1 anterior lumbar interbody fusion.
Patient Data
Large left lower quadrant fluid collection.
Scintigraphic features in this nuclear medicine lymph flow study confirm lymphatic communication with the left abdominal fluid collection.
Case Discussion
A rare complication of lymphocele following anterior lumbar interbody fusion. The initial differential diagnosis included seroma, urine leak, and lymphatic injury. Initial CT findings indicated seroma was less likely given the large volume of fluid and lack of peripheral enhancement. There was no urine extravasation demonstrated on the CT intravenous pyelogram. A subsequent nuclear medicine lymph flow study confirmed lymphatic communication.