Therapeutic lymphangiography for traumatic chylothorax

Area of Science:

• Thoracic Surgery
• Interventional Radiology
• Medical Case Reports

Background:

• Chylothorax, characterized by lymphatic fluid in the pleural space, presents significant clinical challenges.
• Refractory cases often require invasive interventions, with varying success rates.

Observation:

• A 17-year-old female patient with traumatic chylothorax did not respond to conventional medical management.
• Intranodal lymphangiography using an oil-based contrast agent (Lipiodol) was performed.

Findings:

• The procedure led to a substantial decrease in chylous pleural effusion, from 1000 mL/d to 120 mL/d.
• Thoracostomy tube removal was possible, and the patient remained stable with minimal effusion for 19 months post-procedure.

Implications:

• Intranodal lymphangiography with oil contrast represents a promising, less invasive therapeutic option for managing challenging chylothorax cases.
• This technique may offer an alternative to more aggressive surgical interventions.