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Post-lymphangiographic computed tomography in chylothorax after esophagogastrectomy: a case report
D T Ginat1, L G Sahler, N Patel
1Department of Imaging Sciences and Interventional Radiology, University of Rochester Medical Center, Rochester, New York, 14242, USA. ginat01@gmail.com
Lymphology
|November 26, 2009
Summary
Chylothorax after surgery can be challenging. Post-lymphangiography CT imaging effectively visualized thoracic duct leakage, aiding in treatment planning for this rare complication.
Area of Science:
- Thoracic Surgery
- Diagnostic Imaging
- Interventional Radiology
Background:
- Chylothorax is a rare but serious complication following thoracic surgery.
- Lymphangiography is the traditional standard for diagnosing and evaluating chylothorax.
- The utility of post-lymphangiography computed tomography (CT) in chylothorax management remains debated.
Observation:
- A 68-year-old male developed chylothorax post-esophagogastrectomy.
- Conservative management and thoracic duct ligation were unsuccessful.
- Lymphangiography revealed persistent thoracic duct leakage into the right pleural space.
Findings:
- Non-contrast CT and reformatted images precisely identified the sources of thoracic duct leakage.
- This detailed imaging facilitated the planning of a direct percutaneous treatment approach.
- Despite preclusion of planned embolization due to access issues, the CT findings were crucial.
Implications:
- Post-lymphangiography CT imaging offers significant value in evaluating chylothorax.
- This modality can enhance the diagnostic accuracy and guide targeted interventions for chylothorax.
- Further investigation into the role of CT in conjunction with lymphangiography for chylothorax is warranted.