Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption

Authors

  • Tiago Paulino Torres Radiology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal https://orcid.org/0000-0002-0279-8074
  • Pedro Costa General Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal https://orcid.org/0000-0001-6470-0493
  • Herculano Moreira General Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
  • Teresa Dionísio Radiology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Portugal https://orcid.org/0000-0002-5086-7046
  • Pedro Sousa Radiology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Portugal https://orcid.org/0000-0002-8248-1578

DOI:

https://doi.org/10.48729/pjctvs.343

Keywords:

Chylothorax, Lymphangiography, Lipiodol, Thoracic duct, Interventional Radiology

Abstract

Thoracic duct embolization has been increasingly adopted as a first-line therapy of chylothorax and this procedure includes lipiodol lymphangiography, thoracic duct access and embolization. Lymphangiography itself has a therapeutic role, with volume-dependent success rates of 37%-97% and even a reported 100% success rate in outputs of < 500 mL/day. We present a clinical case of a 48-years-old man diagnosed with esophageal squamous cell carcinoma, who underwent esophagectomy and presented with post-operative high-output (> 1L/day) chylothorax; thoracic duct embolization was proposed. Even though thoracic duct access and embolization were not achieved due to technical and anatomical factors, lipiodol lymphangiography and possibly thoracic duct maceration (after several punctures/attempts) contributed to the clinical success of the procedure, and this chylothorax with output values superior to those reported in the literature resolved within three days. As such, the therapeutic role of intranodal lymphangiography and thoracic duct disruption should be taken into account.

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Author Biography

Pedro Sousa, Radiology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Portugal

Head of Department.

References

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Published

09-02-2024

How to Cite

1.
Torres TP, Costa P, Moreira H, Dionísio T, Sousa P. Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption. Rev Port Cir Cardiotorac Vasc [Internet]. 2024 Feb. 9 [cited 2024 Jun. 13];30(4):67-70. Available from: https://pjctvs.com/index.php/journal/article/view/343

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Clinical Cases

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