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Retrograde Transvenous Thoracic Duct Embolization for Tubercular Chylothorax
Prachita Agrawal1, Pankaj Banode1, Shubham Agrawal2
1Department of Interventional Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
This case study highlights a rare instance of chylothorax in a young male, caused by hemophagocytic lymphohistiocytosis and abdominal tuberculosis. Effective management involved a multi-faceted approach including medical and interventional treatments.
Area of Science:
- Pulmonology
- Infectious Diseases
- Hematology
Background:
- Presents a complex case of a 27-year-old male with respiratory distress.
- History of ascites and pleural effusion, returning with an intercostal drain.
Observation:
- Clinical symptoms included dry cough, fatigue, weight loss, fever, dyspnea, and bilateral pulmonary fluid.
- Laboratory findings indicated significant deviations in fluid levels.
Findings:
- Diagnosis of chylothorax secondary to hemophagocytic lymphohistiocytosis (HLH) and abdominal tubercular lymphadenopathy.
- Successful management with anti-tubercular therapy (AKT4), octreotide, non-invasive ventilation (NIV), antibiotics, and intercostal chest drain (ICD).
Implications:
- Demonstrates the successful application of retrograde transvenous thoracic duct embolization (TDE) using N-butyl cyanoacrylate (NBCA) glue.
- Highlights the importance of multidisciplinary collaboration for managing complex cases of chylothorax.
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