Yuta Onikubo1, Shusuke Yagi1, Kazuhiko Yamada2, Daiki Kato1, Hitomi Wake1, Naoki Enomoto1, Kyoko Nohara1, Tsuyoshi Tajima3, Norihiro Kokudo1. 1. Department of Surgery, Center Hospital of the National Center for Global Health and Medicine, 1-21-1, Toyoma, Shinjuku, Tokyo, 162-8655, Japan. 2. Department of Surgery, Center Hospital of the National Center for Global Health and Medicine, 1-21-1, Toyoma, Shinjuku, Tokyo, 162-8655, Japan. kayamada@hosp.ncgm.go.jp. 3. Department of Radiology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1, Toyoma, Shinjuku, Tokyo, 162-8655, Japan.
Abstract
BACKGROUND: Chylothorax is a relatively rare complication of esophagectomy but can lead to fatal conditions. The aim of this report was to present a case of lymphangiography from the para-aortic lymph node (PALN) under computed tomography (CT) guidance, which could be an alternative modality to ultrasound sonography from the groin. CASE PRESENTATION: A 58-year-old man was diagnosed as having postoperative chylothorax after esophagectomy following neoadjuvant chemotherapy. As the pleural effusion did not improve, intranodal lipiodol lymphangiography from the inguinal lymph node was performed but was unsuccessful. Therefore, CT-guided lymphangiography from the left PALN was performed, and the pleural effusion drainage significantly disappeared. CONCLUSIONS: CT-guided lipiodol lymphangiography from the PALN for chylothorax after esophagectomy was safe and thus can be considered an alternative treatment option to ultrasonography-guided intranodal lymphangiography. The flexible use of CT and ultrasonography for lymphangiography may improve the treatment outcomes of chylothorax after esophagectomy.
BACKGROUND: Chylothorax is a relatively rare complication of esophagectomy but can lead to fatal conditions. The aim of this report was to present a case of lymphangiography from the para-aortic lymph node (PALN) under computed tomography (CT) guidance, which could be an alternative modality to ultrasound sonography from the groin. CASE PRESENTATION: A 58-year-old man was diagnosed as having postoperative chylothorax after esophagectomy following neoadjuvant chemotherapy. As the pleural effusion did not improve, intranodal lipiodol lymphangiography from the inguinal lymph node was performed but was unsuccessful. Therefore, CT-guided lymphangiography from the left PALN was performed, and the pleural effusion drainage significantly disappeared. CONCLUSIONS: CT-guided lipiodol lymphangiography from the PALN for chylothorax after esophagectomy was safe and thus can be considered an alternative treatment option to ultrasonography-guided intranodal lymphangiography. The flexible use of CT and ultrasonography for lymphangiography may improve the treatment outcomes of chylothorax after esophagectomy.
Authors: C M Sommer; C C Pieper; F Offensperger; F Pan; H J Killguss; J Köninger; M Loos; T Hackert; M Wortmann; T D Do; G Maleux; G M Richter; H U Kauczor; J Kim; S Hur Journal: Langenbecks Arch Surg Date: 2021-04-12 Impact factor: 3.445