Computed tomography-guided lymphangiography from the para-aortic lymph node: a useful approach for chylothorax after esophagectomy.

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.

• Authors: Yuta Onikubo, Shusuke Yagi, Kazuhiko Yamada, Daiki Kato, Hitomi Wake, Naoki Enomoto, Kyoko Nohara, Tsuyoshi Tajima, Norihiro Kokudo
• Journal: General thoracic and cardiovascular surgery (Gen Thorac Cardiovasc Surg) Vol. 70 Issue 3 Pg. 308-311 (Mar 2022) ISSN: 1863-6713 [Electronic] Japan
• PMID: 34714472 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2021. The Japanese Association for Thoracic Surgery.

Topics

• Chylothorax (diagnostic imaging, etiology, therapy)
• Esophagectomy (adverse effects)
• Humans
• Lymph Nodes
• Lymphography (adverse effects, methods)
• Male
• Middle Aged
• Postoperative Complications (therapy)
• Tomography, X-Ray Computed