title: Sclerotherapy of abdominal lymphatic malformations with doxycycline.
abstract: OBJECTIVE
  To assess the safety and efficacy of percutaneous image-guided sclerotherapy with doxycycline as primary treatment of intraabdominal lymphatic malformations (LMs).
  
  
  METHODS
  Retrospective review was performed of all cases of abdominal, mesenteric, or retroperitoneal LMs referred to a single center that were subsequently treated with image-guided percutaneous sclerotherapy.
  
  
  RESULTS
  Ten patients were included, of whom six were male. The mean age was 13 years (range, 2-28 y). Preprocedural cross-sectional imaging demonstrated a macrocystic malformation in nine patients and a mixed macrocystic/microcystic malformation in one. The malformation was accessed under sonographic guidance, followed by injection of opacified sclerosant agent under fluoroscopic guidance. A drainage catheter was placed in eight cases, in which sclerotherapy was repeated through the catheter for another 1 day (n = 2) or 2 days (n = 6). Doxycycline was reconstituted at 10 mg/mL, with a mean per-session dose of 608 mg (range, 80-1,000 mg) and a mean total dose of 1,230 mg (range, 80-3,000 mg). Peritoneal spill was identified in one case, but the patient remained asymptomatic. No other complications were encountered. Follow-up imaging was available in eight patients: complete resolution was seen in seven, with partial resolution in one. There was no recurrence of clinical symptoms in the follow-up period.
  
  
  CONCLUSIONS
  Initial results indicate that percutaneous image-guided sclerotherapy of macrocystic intraabdominal LMs with doxycycline is a safe and effective procedure.
authors.affiliation: Vascular Anomalies Center, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. gulraiz.chaudry@childrens.harvard.edu
authors.forename: Gulraiz
authors.initials: G
authors.lastname: Chaudry
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Burrows
authors.forename: Horacio M
authors.initials: HM
authors.lastname: Padua
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Dillon
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Fishman
authors.forename: Ahmad I
authors.initials: AI
authors.lastname: Alomari
mesh_terms: D000293:Adolescent; D000328:Adult; D001900:Boston; D002648:Child; D002675:Child, Preschool; D004318:Doxycycline / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D044148:Lymphatic Abnormalities / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D004318:Doxycycline