A Case of Refractory Lymphocele Following Living Donor Kidney Transplantation Treated With Percutaneous Balloon Fenestration Into the Peritoneal Cavity Using Interventional Radiology

Introduction Post‐kidney transplantation lymphocele is a common complication, usually managed with percutaneous drainage, lymphangiography, or surgical fenestration. We report a refractory case successfully treated with percutaneous balloon fenestration into the peritoneal cavity using interventional radiology. Case Presentation A woman in her 60s with end‐stage renal disease from diabetic nephropathy underwent living‐donor kidney transplantation. Two weeks later, a lymphocele developed with a predominant subcutaneous component and a smaller peritransplant retroperitoneal collection, requiring repeated percutaneous aspiration. At 2 months, lymphangiography did not demonstrate an active leak. At 3 months, CT‐guided puncture and dilation were used to create a passage between the lymphocele and the peritoneal cavity, with placement of a 10‐Fr catheter. The catheter was removed after 3 weeks, and no recurrence has been observed for 2.5 years. Conclusion Interventional radiology‐based percutaneous balloon fenestration into the peritoneal cavity may be an effective alternative to surgical fenestration in refractory post‐transplant lymphocele.