scholarly journals A Case Report on the Management of Intractable Chyle Leakage after Left Neck Level V Lymph Node Biopsy

2021 ◽  
Vol 64 (2) ◽  
pp. 124-128
Author(s):  
Somi Ryu ◽  
Byeong Min Lee ◽  
Seongjun Won ◽  
Jung Je Park
Keyword(s):  
Lymph Node ◽  
Thoracic Duct ◽  
Somatostatin Analogues ◽  
Lymph Node Biopsy ◽  
Nutritional Limitation ◽  
Node Biopsy ◽  
Thoracic Duct Ligation ◽  
Duct Ligation ◽  
Left Neck ◽  
Chyle Leakage

Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic or lymphatic duct, is an uncommon complication of head and neck surgeries, which include neck dissection or thyroidectomy. A small amount of chyle leakage can be treated with conservative approaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of the wound and thoracic duct ligation via the chest or transabdominal thoracic duct embolization can be applied. Here, we report a case of intractable massive chyle leakage in a 78-year-old male after a left neck level V lymph node biopsy, which was not controlled after conservative management and explorative surgery. Various treatment approaches were attempted and successful management of chyle leakage was ultimately achieved by thoracic duct embolization.

scholarly journals A case of oral cancer successfully treated with thoracoscopic thoracic duct ligation for persistent chyle leakage after neck dissection

2013 ◽  
Vol 25 (3) ◽  
pp. 115-121
Author(s):  
On Hasegawa ◽  
Takafumi Satomi ◽  
Masato Watanabe ◽  
Harutsugi Abukawa ◽  
Michihide Kono ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Neck Dissection ◽  
Thoracic Duct ◽  
Thoracic Duct Ligation ◽  
Duct Ligation ◽  
Chyle Leakage

scholarly journals Sarcoidosis with secondary recurrent right-sided chylothorax and chylous ascites in a Caucasian male patient

2021 ◽  
Vol 2021 (10) ◽  
Author(s):  
Sujaay Hari Jagannathan ◽  
Caleb M Winn ◽  
Arun P Nayar ◽  
Ghassan J Koussa ◽  
Carol A Brenner
Keyword(s):  
Thoracic Duct ◽  
Mediastinal Lymph Node ◽  
Chylous Ascites ◽  
Lymph Node Biopsy ◽  
Surgical Trauma ◽  
Surgical Interventions ◽  
Caucasian Male ◽  
Fluid Analysis ◽  
Thoracic Duct Ligation ◽  
Duct Ligation

ABSTRACT Sarcoidosis is a rare multisystem autoimmune disease characterized by the presence of non-caseating granulomas in involved organs. We report a novel case of a 61-year-old Caucasian male with sarcoidosis presenting with recurrent chylothorax and chylous ascites. Pleural and ascitic fluid analysis revealed high triglyceride levels, consistent with chylothorax and chylous ascites, respectively. Common etiologies of chylous fluid such as thoracic duct surgical trauma, malignancy and infection were all excluded. Sarcoidosis was confirmed by the presence of non-caseating granulomas on a mediastinal lymph node biopsy. Conservative treatment with low-fat diet, prednisone, octreotide and multiple thoracenteses failed to effectively resolve the chylothorax. Surgical interventions with pleurodesis and thoracic duct ligation were performed, leading to the complete resolution of the chylous effusion and ascites.

scholarly journals Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

2014 ◽  
Vol 59 (No. 6) ◽  
pp. 276-282
Author(s):  
D. Vnuk ◽  
A. Gudan Kurilj ◽  
D. Maticic ◽  
G. Dupre
Keyword(s):  
Methylene Blue ◽  
Lymph Node ◽  
Thoracic Duct ◽  
Popliteal Lymph Node ◽  
Lymph Vessel ◽  
Total Occlusion ◽  
Thoracic Duct Ligation ◽  
Duct Ligation ◽  
Radiographic Contrast ◽  
The Right

Radiographic contrast studies have been recommended to identify the thoracic duct (TD) and its branches before and after surgery for total occlusion. The macroscopic identification of the TD and its branches during surgery usually involves injection of methylene blue (MB). Radiographic contrast and methylene blue can be injected into different anatomical structures (lymph node, lymph vessel, s.c.). The purpose of this study was to compare two different techniques (radiographic and thoracoscopic) for visualisation of the TD after intrapopliteal lymph node injection in the pig. Six piglets from the same litter (two males and four females), two months of age were used. Iohexol at 245 mg/ml was injected into the left popliteal lymph node (LN) under general anaesthesia; hindlimb, abdominal, and thoracic radiographs were taken. A 0.25% methylene blue solution was injected into the right popliteal lymph node and the thoracic duct colouration was assessed thoracoscopically. The thoracic duct was visualised radiographically in one out of six pigs after iohexol injection and thoracoscopically in five out of six pigs after methylene blue injection. The difference was statistically significant (P = 0.040). Popliteal LN lymphangiography using iohexol at 245 mg/ml in piglets should not be the recommended method for TD visualisation. Intrapopliteal injection of a 0.25% solution of methylene blue is recommended as a method of TD visualisation prior to thoracic duct ligation.  

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