Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes...

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Main Authors: Tomoyuki Ishida, Jun Kanamori, Hiroyuki Daiko
Format: Article
Language:English
Published: Japan Surgical Society 2019-12-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-019-0709-3
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author Tomoyuki Ishida
Jun Kanamori
Hiroyuki Daiko
author_facet Tomoyuki Ishida
Jun Kanamori
Hiroyuki Daiko
author_sort Tomoyuki Ishida
collection DOAJ
description Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.
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spelling doaj-art-28445b590c17456384f55dd9ea98cc022025-08-20T03:15:05ZengJapan Surgical SocietySurgical Case Reports2198-77932019-12-01511510.1186/s40792-019-0709-3Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case reportTomoyuki Ishida0Jun Kanamori1Hiroyuki Daiko2Department of Esophageal Surgery, National Cancer Center HospitalDepartment of Esophageal Surgery, National Cancer Center HospitalDepartment of Esophageal Surgery, National Cancer Center HospitalAbstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.https://doi.org/10.1186/s40792-019-0709-3Thoracic ductChylothoraxOesophageal cancerVariation
spellingShingle Tomoyuki Ishida
Jun Kanamori
Hiroyuki Daiko
Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report
Surgical Case Reports
Thoracic duct
Chylothorax
Oesophageal cancer
Variation
title Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report
title_full Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report
title_fullStr Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report
title_full_unstemmed Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report
title_short Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report
title_sort lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy a case report
topic Thoracic duct
Chylothorax
Oesophageal cancer
Variation
url https://doi.org/10.1186/s40792-019-0709-3
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AT junkanamori lymphangiographyandfocalpleurodesistreatmentofchylothoraxwithanaberrantthoracicductfollowingoesophagectomyacasereport
AT hiroyukidaiko lymphangiographyandfocalpleurodesistreatmentofchylothoraxwithanaberrantthoracicductfollowingoesophagectomyacasereport