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Chylothorax after esophagectomy cured by intranodal lymphangiography: a case report
Masaaki Yamamoto1, Hiroshi Miyata2, Makoto Yamasaki1
1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Abstract:
This is a case report of chylothorax after esophagectomy for esophageal cancer cured by intranodal lymphangiography in the groin. A 62-year-old man was admitted to our Hospital with dysphagia. The diagnosis was made of advanced esophageal cancer (T3N1M0, stage IIIA). After neoadjuvant chemotherapy, radical surgery was performed. On postoperative day (POD) 9, left pleural effusion drainage increased sharply and changed to a milky white color, leading to a diagnosis of chylothorax. Although chylothorax was managed with conservative treatment, there was an inadequate response to it. On POD 15, lymphangiography was performed. Inguinal nodes were directly accessed under ultrasound guidance and lipiodol was injected into nodes. After the lymphangiography, the left pleural effusion drainage immediately decreased. On POD 40, the patient was discharged. To the best of our knowledge, this is the first report of a chylothorax after esophagectomy for esophageal cancer to be cured by ultrasound-guided intranodal lymphangiography in the groin.
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