• Cardiovasc Intervent Radiol · Aug 2014

    Case Reports

    CT-guided injection of N-butyl cyanoacrylate glue for treatment of chylous leak after aorto-mesenteric bypass.

    • Kevin C Ching, Ernesto Santos, Kevin McCluskey, and Geetha Jeyabalan.
    • Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, 3950 Presby South Tower, Pittsburgh, PA, 15213, USA, chingk@upmc.edu.
    • Cardiovasc Intervent Radiol. 2014 Aug 1; 37 (4): 1103-6.

    AbstractLymphangiography and thoracic duct embolization are well-described techniques for the diagnosis and treatment of thoracic lymphatic leaks refractory to conservative treatment. However, thoracic duct embolization is not an option in patients with abdominal chylous leaks. The present report describes a 68-year-old man who underwent an aortomesenteric bypass complicated by a high-output postoperative chylothorax (>2,000 ml/day) and chylous ascites (>7,000 ml/paracentesis). Ultrasound-guided intranodal lymphangiography demonstrated a retroperitoneal lymphatic leak tracking along the vascular graft into the peritoneal cavity. Computed tomography-guided lymphatic duct occlusion with N-butyl cyanoacrylate glue was performed, resulting in successful treatment of both chylothorax and chylous ascites.

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