• Head & neck · Feb 2014

    Case Reports

    Ultrasound-guided intranodal lymphangiography followed by thoracic duct embolization for treatment of postoperative bilateral chylothorax.

    • Ahmad Parvinian, Girish C Mohan, Ron C Gaba, David F Saldanha, M Grace Knuttinen, James T Bui, and Jeet Minocha.
    • Department of Radiology, Interventional Radiology Section, College of Medicine, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
    • Head Neck. 2014 Feb 1;36(2):E21-4.

    BackgroundPercutaneous thoracic duct embolization (TDE) is a safe, effective, and minimally invasive option for treating chylothorax. A recent report demonstrated the feasibility of ultrasound-guided intranodal lymphangiography as an alternative to pedal lymphangiography for visualization of the thoracic duct, promising relative technical ease and decreased procedure time for TDE.MethodsWe report a case of postoperative bilateral chylothorax treated with ultrasound-guided intranodal lymphangiography followed by TDE.ResultsIntranodal lymphangiography resulted in rapid opacification of the abdominal lymphatics, permitting technically successful primary and secondary embolization procedures. Deployment of metallic coils and liquid embolic agents within the thoracic duct produced rapid clinical and radiographic improvement.ConclusionIntranodal lymphangiography is a reliable, reproducible, and less technically challenging alternative to pedal lymphangiography.Copyright © 2013 Wiley Periodicals, Inc.

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