EC Paediatrics

Abdominal lymphatic malformation account for less than 5% of all congenital lymphatic malformations. Although antenatal diagnosis is ascertained in some cases, postnatal imaging is essential to confirm the diagnosis, delineate the extent of the lesion, and provide an insight for possible therapeutic interventions. While surgical excision is considered the only curative measure, conservative management is recommended when the lesion is small and does not affect the anatomy or function of other intra-abdominal organs. Sclerotherapy is seldom used as the only therapy but is indicated when the lesion is large and invading nearby structures, although surgical excision might be warranted as an emergency intervention when the lesion is complicated by rapid enlargement, hemorrhage, infection, volvulus, or acute compartment syndrome.

We hereby present a case of abdominal lymphatic malformation diagnosed antenatally at 24-week gestation as suspected intestinal obstruction. Postnatal imaging confirmed a massive retroperitoneal macrocystic lymphatic malformation invading nearby structures. Conservative management was initially attempted, local drainage was achieved at the age of three weeks, sclerotherapy was done at two months, and laparotomy with excision performed at four months with an excellent overall outcome.

 Keywords: Abdominal Lymphatic Malformation; Neonate; Sclerotherapy; Antenatal

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