Related Experiment Video
Updated: Jul 9, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Thoracic duct disruption without lymphangiographic thoracic duct visualization for refractory chylothorax: A case
Takaki Hirano1, Masayoshi Yamamoto1, Hiroshi Kondo1
1Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan.
Abstract:
Percutaneous treatments, including thoracic duct embolization (TDE) and thoracic duct disruption (TDD), are reportedly effective and safe alternatives to surgical thoracic duct ligation for refractory chylothorax. When catheterization of the thoracic duct is impossible, TDD can be performed as long as the thoracic duct can be opacified by lymphangiography. However, no report has described percutaneous treatment when the thoracic duct cannot be visualized. In this case, TDE was not feasible because intranodal lymphangiography failed to opacify the thoracic duct: cannulation was not achieved. Therefore, we aimed to disrupt the thoracic duct by puncturing the retrocrural area where it was anatomically suspected to be located. Chylothorax improved thereafter. In cases without lymphangiographic thoracic duct visualization, TDD by puncturing the retrocrural space might improve refractory chylothorax.
Related Concept Videos
Pneumothorax-II
Clinical Manifestations:
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...

