Lymphangiography and thoracic duct embolization for persistent chyle leak following augmentation mammoplasty and mastopexy

Abstract

Chyle leak is a relatively rare post-operative complication of breast and axilla surgery, and the majority of these cases can be managed conservatively. We present the case of a 42-year-old female with chyle leak within the external thoracic cavity following elective augmentation mammoplasty and mastopexy. This patient failed initial operative management consisting of implant removal, washout, suture plication, and intra-operative drain placement as well as subsequent conservative management including diet modification, total parenteral nutrition, and percutaneous aspiration. Ultimately, this patientʼs chyle leak was successfully managed with lymphangiography and thoracic duct embolization. To our knowledge, this is the first documented case of successful use of lymphangiography with embolization to manage chyle leak within the superficial chest, and this intervention should be considered when contemplating management of this post-operative complication within the breast cavity.

Keywords

• Mammoplasty
• Breast implant
• Chyle leak
• Thoracic duct injury
• Lymphangiography
• Embolization