After your child has sclerotherapy for a lymphatic malformation

This page explains how to look after your child after they have had sclerotherapy of a lymphatic malformation at Great Ormond Street Hospital (GOSH) and what to expect in the days following treatment.

The medicine injected into the lymphatic malformation may make the area swell over the first week or two. The area may also be red, bruised and feel slightly tender. These effects are normal and show that the medicine is having an effect. Most children only need a dose or two of children’s pain medicine, such as paracetamol or ibuprofen. Any swelling should start to go down within a week but the effects of the treatment, such as a decrease in pain or size, may not be obvious for a couple of months.

Lymphatic malformations are also prone to blood clots forming inside the cysts. Your child’s lymphatic malformation may have shown signs of this in the past, such as sudden swelling and bruising. Treating the lymphatic malformation may provoke another bleed in the week following treatment. If this occurs, give your child a dose or two of children’s pain medicine. The bleed or clot usually settles without treatment, in which case it will not affect how well the sclerotherapy works. If the clot stays big and hard for more than two weeks, your child may need the procedure to be repeated. Please call the IR department to tell us about this (details below).

Treating the lymphatic malformation may provoke an infection following treatment. An infection makes the area more swollen, hot and painful than expected rather like an abscess. Your child will have a high temperature and feel generally unwell. If this occurs, your child may need a short course of oral antibiotics from your family doctor (GP).

There is a very small risk that your child’s blood sugar level could drop slightly after this treatment, but as they will be closely watched on the ward, this is unlikely to happen. Their blood sugars will be tested every two hours for the first six hours after the procedure to make sure they are normal.

There is a small risk that your child’s blood sugar level could fall when you get home, especially if they are refusing food and/or vomiting. This is called 'hypoglycaemia’. Signs of hypoglycaemia include:

• „„vomiting
• „„ irritability
• „„ sweating
• „„pallor (pale tinge to skin)
• „„change of mood or behaviour
• „„generally not being well

You should call the ward (telephone number at the end of this leaflet) or your GP if your child has any of these symptoms of hypoglycaemia. You can prevent hypoglycaemia by giving your child regular feeds such as a milky or sugary drink to refill their energy stores. If they are able to take solids, high carbohydrate foods such as bread or pasta are advised.