ABSTRACT
Lymphangiography and percutaneous embolization has been described for the treatment of thoracic duct injury, usually occurring in the postsurgical period. We report a case of a traumatic gunshot-induced massive chylothorax. Inguinal lymphangiogram was performed demonstrating the site of injury at the cisterna chyli. The cisterna chyli was successfully accessed via a percutaneous approach, and embolization was performed. Chylothorax immediately resolved after two rounds of embolization. Although lymphangiography has been traditionally challenging and cumbersome, because of the need for pedal lymph access, the recent use of inguinal lymphangiography has made this technique more practical. Techniques used for embolization of the thoracic duct may be applied to the cisterna chyli, which is much more challenging to treat surgically.
Subject(s)
Chylothorax/therapy , Embolization, Therapeutic/methods , Lacerations/therapy , Lymphography/methods , Thoracic Duct/injuries , Wounds, Gunshot/therapy , Chylothorax/etiology , Ethiodized Oil/administration & dosage , Fluoroscopy , Humans , Male , Ultrasonography, Interventional , Wounds, Gunshot/complications , Young AdultABSTRACT
BACKGROUND: We report two cases of vascular complications after reconstructive pelvic surgery successfully treated with pelvic artery embolization. CASES: Two patients who underwent mesh placement complicated by postoperative pelvic hemorrhage were treated successfully with selective arterial embolization. CONCLUSION: The widespread adoption of reconstructive pelvic surgery procedures with dissection in deep vascular spaces has brought with it the prospect of challenging vascular morbidity. A thorough understanding of pelvic anatomy is essential for management of vascular complications from reconstructive pelvic surgery.
