Radiology Case Reports (Aug 2020)

Chylothorax treated with targeted sclerotherapy by direct puncture of the lymphatic leakage site

  • Masamichi Takahashi, MD,
  • Masanori Inoue, MD, PhD,
  • Tomoki Wada, MD, PhD,
  • Go Kawai, MD,
  • Munetaka Machida, MD,
  • Yujiro Matsuoka, MD, PhD

Journal volume & issue
Vol. 15, no. 8
pp. 1398 – 1402

Abstract

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We report a novel application of targeted sclerotherapy to eradicate high-output chylothorax. The patient underwent thoracic duct embolization; however, cannulation of the thoracic duct failed, and thoracic duct disruption was performed. Leakage continued; therefore, the leakage site in the mediastinum was punctured directly under fluoroscopic guidance and a drainage catheter was inserted, followed by sclerotherapy using OK-432. Finally, leakage stopped and chylothorax improved. This technique may be useful for refractory chylothorax in patients where thoracic duct embolization fails.

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