SURGICAL TREATMENT OF POST-TRAUMATIC LYMPHOCELE OF THE THIGH DEVELOPED DUE TO BARIC TRAUMA CAUSED BY AN AUTOMOBILE WHEEL

Background. A lymphocele is an acquired cystic formation containing lymph and, in the vast majority of cases, is an iatrogenic complication (following lymphadenectomy, vascular surgery, kidney transplantation). Spontaneous and post-traumatic lymphoceles of soft tissues without bone fracture are extremely rare. In the available Russian literature, there are no descriptions of post-traumatic lymphoceles of the thigh formed after baric trauma (being run over by a car).

Case description. A 37-year-old male. The mechanism of injury was the wheel of a 1.4-ton car crossing the middle third of the left thigh while the patient was in a horizontal position. There was no fracture due to the limb being "pressed into" soft ground. On the 2nd day after the injury, a painless mass appeared on the inner surface of the thigh, which increased upon verticalization. On the 5th day, the diameter of the mass reached 15 cm.

Ultrasound with color Doppler mapping was performed, which ruled out a false aneurysm of the femoral artery and verified a lymphocele with a volume of 50 ml containing a single septum. Open excision with cavity suturing was performed. The postoperative period was uneventful. No recurrence was noted after 21 days.

Conclusion. A case of post-traumatic thigh lymphocele in the absence of a fracture is described for the first time in the Russian literature. Ultrasound with color duplex mapping is the "gold standard" for differential diagnosis. Open excision is indicated for a septate (loculated) structure due to the ineffectiveness of sclerotherapy.

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