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Postoperative chylothorax after left pulmonary wedge resection without mediastinal lymph node dissection: a case
Li Chen1, Bo Tian1, Shaohua Xie1
1Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Journal of Surgical Case Reports
|January 13, 2023
Summary
Postoperative chylothorax, a rare complication after lung surgery, can occur even after left pulmonary wedge resection. Magnetic resonance-thoracic ductography (MRTD) guided successful surgical intervention for a refractory case.
Area of Science:
- Thoracic Surgery
- Medical Imaging
- Gastroenterology
Background:
- Postoperative chylothorax is a rare but serious complication following pulmonary resections.
- While not previously reported after left pulmonary wedge resection, anatomical variations of the thoracic duct pose a risk.
Observation:
- A case of refractory chylothorax occurred after left pulmonary wedge resection without mediastinal lymph node dissection.
- Initial conservative management and supradiaphragmatic thoracic duct ligation proved ineffective.
Findings:
- Magnetic resonance-thoracic ductography (MRTD) precisely located the thoracic duct fistula.
- Successful surgical ligation of the thoracic duct fistula was achieved under MRTD guidance.
Implications:
- MRTD is a valuable tool for identifying thoracic duct anatomy and fistulas.
- This technique can facilitate precise surgical intervention for complex chylothorax cases.
- Highlights the potential risk of chylothorax even in specific pulmonary resection procedures.
