Dual imaging lymphangiography guided treatment of infantile chylothorax

Kohei Mitsui; Mitsunaga Narushima; Ryohei Ishiura; Kanako Danno; Yosuke Sakakura; Chihena H Banda

doi:10.1016/j.jvscit.2021.06.007

Dual imaging lymphangiography guided treatment of infantile chylothorax

J Vasc Surg Cases Innov Tech. 2021 Jul 1;7(3):492-495. doi: 10.1016/j.jvscit.2021.06.007. eCollection 2021 Sep.

Authors

Kohei Mitsui^{1

2}, Mitsunaga Narushima¹, Ryohei Ishiura¹, Kanako Danno¹, Yosuke Sakakura³, Chihena H Banda¹

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan.
² Department of Plastic and Reconstructive Surgery, Aichi Medical University, Nagakute, Japan.
³ Department of Clinical Anesthesiology, Graduate School of Medicine, Mie University, Tsu, Japan.

Abstract

Chylothorax is a potentially fatal postoperative complication of neck, thoracic, and abdominal surgery in children. We report the case of a 3-month-old infant who developed persistent chylothorax with respiratory insufficiency successfully managed using a microsurgical technique and intraoperative embolotherapy. This was achieved using a combination of intermittent digital X rays and live near-infrared fluorescence imaging we have termed "dual imaging lymphangiography" to guide therapy in real time. The chylothorax resolved and the patient returned to normal diet without recurrence. This microsurgical approach with dual imaging lymphangiography provides a useful tool for intraoperative visualization and treatment of complicated chylothoraces.

Keywords: Chylous ascites; Chylous leak; Infantile chylothorax; Lymphangiography; Microsurgery techniques.

Publication types

Case Reports