23 September 2026
: Case report 
Refractory Chylous Ascites After Robot-Assisted Radical Prostatectomy With Sequential Anatomically Distinct Lymphatic Leak Sites Identified by Repeat Lymphangiography
Unusual clinical course, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)
Takayuki Owaki
ABCDEFG 1,2*, Yasuhito Funahashi ABE 1,3, Kosuke Tochigi B 1,4, Ryota Hyodo BDF 5, Wataru Nakane B 1,6, Masaya Matsushima B 5,7, Shusuke Akamatsu E 1
DOI: 10.12659/AJCR.954777
Am J Case Rep 2026; 27:e954777
Figure 1 Lymphangiography images(A) Initial lymphangiography performed on postoperative day (POD) 87. The cyan arrow indicates the internal iliac lymphatic leakage site. The yellow line and arrow demonstrate retrograde lymphatic flow through the pelvic lymphatic channels. The orange arrow indicates the puncture site. (B) Repeat lymphangiography performed on POD 108. The cyan arrow indicates a new lymphatic leak in the external iliac region, anatomically distinct from the original internal iliac leak site. The yellow line and arrow demonstrate retrograde lymphatic flow through the collateral pathway. The orange arrow indicates the puncture site. These findings suggest redistribution of lymphatic flow through collateral pathways following ligation of the primary leak.