Post‐prostatectomy chylous ascites treated by intranodal lymphangiography: A case report and review

Abstract Chylous ascites is a rare but significant complication following extended pelvic lymph node dissection (ePLND) during radical prostatectomy. No universal treatment guideline currently exists. Herein, we present the case of a 74‐year‐old patient with prostate cancer who developed chylous ascites after radical prostatectomy with bilateral ePLND. Persistent ascites continued despite a medium‐chain triglyceride diet, octreotide, and percutaneous drainage. Lymphoscintigraphy confirmed lymphatic leakage but failed to localise the source. Ultimately, intranodal lymphangiography with Lipiodol was performed, which identified and sealed the leakage site, sparing the patient from surgical intervention. Follow‐up imaging showed only a small, resolving lymphocele, and the patient remained asymptomatic at 3 months. This case highlights the diagnostic and therapeutic value of intranodal lymphangiography with Lipiodol in managing post‐operative chylous ascites.