Endolymphatic exclusion for the treatment of pediatric chylous ascites secondary to neuroblastoma resection: report of two cases

Andrew Woerner, MD, MS; David S. Shin, MD; Jeffrey Forris Beecham Chick, MD, MPH, FSVM; Caitlin A. Smith, MD; Jay F. Sarthy, MD, PhD; Eric J. Monroe, MD

Radiology Case Reports (Jul 2020)

Endolymphatic exclusion for the treatment of pediatric chylous ascites secondary to neuroblastoma resection: report of two cases

Andrew Woerner, MD, MS,
David S. Shin, MD,
Jeffrey Forris Beecham Chick, MD, MPH, FSVM,
Caitlin A. Smith, MD,
Jay F. Sarthy, MD, PhD,
Eric J. Monroe, MD

Affiliations

Andrew Woerner, MD, MS: Interventional Radiology Section, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
David S. Shin, MD: Interventional Radiology Section, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
Jeffrey Forris Beecham Chick, MD, MPH, FSVM: Interventional Radiology Section, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA; Division of Vascular and Interventional Radiology, Department of Radiology, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
Caitlin A. Smith, MD: Department of General Surgery, University of Washington and Seattle Children's Hospital, Seattle, WA, USA
Jay F. Sarthy, MD, PhD: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA
Eric J. Monroe, MD: Interventional Radiology Section, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA; Division of Vascular and Interventional Radiology, Department of Radiology, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA; Corresponding author.

Journal volume & issue: Vol. 15, no. 7
pp. 1044 – 1049

Abstract

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Chylous ascites is a rare, but highly morbid complication of oncologic resection, often associated with retroperitoneal lymphadenectomy. Conservative measures with total parenteral nutrition or lipid-reduced formulas constitute the initial mainstay therapy, but not without risks and failures. This report describes 2 endolymphatic treatment strategies for iatrogenic chylous ascites following neuroblastoma resection. Lymphatic leaks were identified using intranodal lymphangiography, targeted with cone-beam computed tomographic guidance, and embolized with n-butyl cyanoacrylate. There were no adverse outcomes, with complete resolution of chylous ascites and a mean follow-up of 26 months.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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