Name of the Procedure:

Injection procedure; lymphangiography

Summary

Lymphangiography is a diagnostic imaging procedure used to visualize the lymphatic system. It involves injecting a contrast dye into the lymphatic vessels, usually in the foot, to help identify blockages, leaks, or other abnormalities in the lymphatic system.

Purpose

Lymphangiography is primarily used to diagnose conditions related to the lymphatic system. It can help identify blockages, leaks, tumors, or infections within the lymphatic vessels. The goal is to provide detailed images that can aid in diagnosing and planning treatment for lymphatic diseases or conditions.

Indications

• Swelling (lymphedema)
• Suspected lymphatic blockage
• Assessment of lymphatic spread of cancer
• Pre-surgical evaluation of lymphatic anatomy
• Unexplained fluid accumulation (chylous ascites or pleural effusion)

Preparation

• Fasting for a few hours before the procedure, as advised by the physician.
• Discontinuation or adjustment of certain medications.
• Preliminary blood tests to check for any bleeding disorders.
• Informing the doctor of any allergies to contrast dye or iodine.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. An initial injection of a blue dye may be administered to outline the lymphatic vessels.
3. Once the vessels are identified, a contrast dye is injected into a lymphatic vessel, typically in the foot or hand.
4. X-ray images are then taken as the dye travels through the lymphatic system, capturing detailed images of the lymph vessels and nodes.
5. The procedure may involve local anesthesia to minimize discomfort at the injection site.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Lymphangiography is performed in a hospital radiology department or a specialized outpatient clinic.

Personnel

• Radiologist
• Radiologic Technologist
• Nursing Staff
• Occasionally, an anesthesiologist if sedation is required

Risks and Complications

• Allergic reactions to the contrast dye
• Infection at the injection site
• Blood clots
• Inflammation of the lymphatic vessels (lymphangitis)
• Temporary limb swelling

Benefits

• Accurate diagnosis of lymphatic conditions
• Detailed visualization of the lymphatic system for treatment planning
• Identification of lymphatic spread of cancer
• Essential information for surgical planning in lymphatic surgery

Recovery

• Patients are usually monitored for a short while after the procedure.
• Instructions may include resting the injected limb and avoiding strenuous activities for a day or two.
• Keeping the injection site clean and dry.
• Follow-up appointments may be necessary to review results and discuss further treatment.

Alternatives

• Lymphoscintigraphy: A less invasive imaging technique using radioactive tracers.
• Magnetic Resonance Imaging (MRI): For detailed soft tissue imaging.
• Ultrasound: Non-invasive imaging option for superficial lymphatic structures.
• Each alternative has its own pros and cons, including differences in accuracy, invasiveness, and side effects.

Patient Experience

Patients might feel a brief sting or pinch during the injection of the dye. There might be some discomfort or swelling at the injection site. Pain management will be provided as needed, and the healthcare team will ensure the patient is comfortable throughout the procedure. Post-procedure, most patients can resume normal activities within a few days, following the provided care instructions.