Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Lymphangiography, Pelvic/Abdominal, Unilateral Common Names: Lymphatic Imaging, Lymph Node X-ray
Summary
Lymphangiography is a specialized imaging procedure used to visualize the lymphatic system in the pelvic or abdominal region. This process involves injecting a contrast dye into the lymphatic vessels and taking X-ray images to identify any blockages, abnormalities, or diseases.
Purpose
The primary goal of lymphangiography is to diagnose problems within the lymphatic system, such as blockages, tumors, or infections. By identifying these issues, healthcare providers can plan appropriate treatment strategies and monitor the effectiveness of interventions.
Indications
This procedure is typically recommended for patients who have:
- Swelling (lymphedema) of the legs or abdomen
- Suspected lymphoma or other cancers
- Unexplained pelvic or abdominal pain
- Abnormal lymph nodes detected through other imaging tests
- Symptoms indicating potential lymphatic system disease
Preparation
Patients may be asked to:
- Fast for several hours before the procedure
- Inform their doctor about any medications they are taking
- Undergo blood tests or other diagnostic exams to assess their overall health
- Arrive with a companion to assist with transportation post-procedure
Procedure Description
- The patient lies on an X-ray table.
- A local anesthetic is applied to numb the injection site.
- A small incision is made to access a lymphatic vessel.
- A contrast dye is injected into the vessel, allowing for clear visualization on X-ray images.
- A series of X-ray images are taken to map the lymphatic vessels and nodes.
- The procedure typically concludes with a bandage applied to the incision site.
Equipment Used:
- X-ray machine
- Catheters
- Contrast dye
- Local anesthesia
Duration
The procedure usually takes between 1 to 2 hours.
Setting
Lymphangiography is performed in a hospital's radiology or imaging department, typically on an outpatient basis.
Personnel
- Radiologist (specializes in imaging procedures)
- Radiologic technologist
- Nurse or medical assistant
Risks and Complications
Common risks include:
- Pain at the injection site
- Allergic reaction to the contrast dye
- Infection at the injection site
Rare complications might involve:
- Blood clots
- Damage to lymphatic vessels
- Kidney problems from the contrast dye
Benefits
- Accurate diagnosis of lymphatic system disorders
- Guides treatment planning for conditions like cancer and lymphedema
- Non-invasive compared to surgical exploratory methods
- Immediate visual results
Recovery
After the procedure:
- Patients should rest and limit physical activity for 24 hours.
- Keep the injection site clean and dry.
- Follow any pain management or antibiotic instructions given.
- Schedule follow-up appointments as needed.
Most patients can resume normal activities within a day, but should avoid strenuous activities for a short period.
Alternatives
- CT Scan or MRI: Non-invasive imaging without dye injection, but may lack detailed lymphatic visualization
- Ultrasound: Useful for initial assessment but less detailed
- Biopsy: More invasive, used if a more definitive tissue diagnosis is needed
Patient Experience
During the procedure, patients may feel a mild sting or pressure from the injection. Some may experience warmth from the contrast dye. Post-procedure, mild discomfort at the injection site is common but usually manageable with pain relievers. Anxiety or discomfort related to lying still for an extended period can be alleviated with relaxation techniques or mild sedatives, if necessary.