Postoperative Chylothorax: the Use of Dynamic Magnetic Resonance Lymphangiography and Thoracic Duct Embolization

Dynamic enhanced magnetic resonance lymphangiography can be used to provide anatomic and dynamic information for various lymphatic diseases, including thoracic duct injury, and can also help to guide the thoracic duct embolization procedure. We present a case of postoperative chylothorax demonstrated by dynamic enhanced MR lymphangiography. In this case, the chyle leakage site and location of cisterna chyli were clearly visualized by dynamic enhanced MR lymphangiography, thus allowing for management with thoracic duct embolization.

A Case of Percutaneous Thoracic Duct Embolization for Chylothorax after Total Arch Replacement / 日本心臓血管外科学会雑誌

<p>The patient was 70-year-old man. Distal aortic arch aneurysm of the maximum diameter of 55 mm was pointed out by Computed tomography. He underwent total arch replacement with median sternotomy. The next day, white cloudy fluid was flowing out from his left thoracic drain, and the amount increased and chylothorax was diagnosis. We selected conservative therspy with fasting and octoleotide subcutaneous injection. After 19 days chylothorax did not improve. We performed percutaneous thoracic duct embolization which is minimam invasive therapy. After embolization, he could start the meal, and the chest drain was extubated. He was discharged in good condition 49 days after first operation.</p>