Lymphangiography in the Diagnosis and Localization of Various Chyle Leaks.
Summary of "Lymphangiography in the Diagnosis and Localization of Various Chyle Leaks."
Chyle leaks are rare entities infrequently encountered by most physicians. However, large centers providing advanced surgical care are inevitably confronted with chyle leaks as a complication of surgery, an extension of disease, or as a primary disorder. Regardless of the etiology, proper diagnosis and localization are paramount in the management of any chyle leak. MATERIALS AND
Here we present 16 patients with 17 chyle leaks (5 chyluria, 8 chylothorax, and 4 chylous ascites) who underwent bipedal lymphangiography (LAG) and postprocedure computed tomography (CT) imaging.
In each case, the source of the chyle leak was identified and properly localized to guide further treatment. Of the 16 patients who underwent LAG and postprocedure CT imaging, the initial LAG alone provided the diagnosis and localized the chyle leak in 4 patients (25%); the postprocedure CT imaging provided the diagnosis and localized the chyle leak in 6 patients (37.5%); and the two modalities were equal in the diagnosing and localizing the chyle leak in the remaining 6 patients (37.5%)
These cases highlight the unparalleled abilities of LAG and the added benefit of post-LAG CT imaging in the diagnosis and fine anatomic localization of chyle leaks. In addition, these cases demonstrate the retained utility of LAG in these investigations despite the development of alternative tests involving CT, magnetic resonance imaging, and nuclear medicine imaging.
Department of Medicine Transitional Year Residency Program, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA.
This article was published in the following journal.
Name: Cardiovascular and interventional radiology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21161658
- DOI: http://dx.doi.org/10.1007/s00270-010-0066-x
Chylothorax following resection for esophageal carcinoma is a relatively rare complication. There is no proven therapy for chylothorax. We report 5 cases of chylothorax following resection for esophag...
Background Imaging of the lymphatic system is difficult because of its structural and anatomical characteristics, and the conventional diagnostic method, radionuclide-based imaging, has the disadvan...
Anastomotic leaks after colorectal resections for cancer are a leading cause of postoperative morbidity, mortality, and long hospital stay. Few data exist on the potentially deleterious effect of the ...
Spontaneous cerebrospinal fluid (CSF) leaks/encephaloceles are proven to be associated with intracranial hypertension by objective measurements of CSF pressure during or following endoscopic repair. A...
Pipeline safety in the United States has increased in recent decades, but incidents involving natural gas pipelines still cause an average of 17 fatalities and $133 M in property damage annually. Natu...
The investigators hypothesized that increasing non intentional leaks could increase work of breathing and could lead to patient/non-invasive ventilation (NIV) asynchrony. The main objecti...
The purpose of this study is to determine whether a new surgical technique (radioguided seed localization) for localizing nonpalpable breast tumours is better than the standard technique (...
The goal of this clinical research study is to evaluate how well ferumoxtran-10, a new Magnetic Resonance Imaging (MRI) contrast agent, can detect cancer in the pelvic lymph nodes or malig...
A new method for localization of the prostate during external beam radiotherapy. The method is based on insertion of a new thermo-expandable Ni-Ti stent. The radiological properties of the...
More than 50% of diabetic patients suffer from neuropathy, potentially making them more susceptible to further nerve injury following regional anesthesia. Key to regional anesthesia is loc...
Medical and Biotech [MESH] Definitions
The presence of chyle in the thoracic cavity. (Dorland, 27th ed)
Presence of milky lymph (CHYLE) in the PERITONEAL CAVITY, with or without infection.
An opaque, milky-white fluid consisting mainly of emulsified fats that passes through the lacteals of the small intestines into the lymphatic system.
An embryonic structure originating from the ALLANTOIS. It is a canal connecting the fetal URINARY BLADDER and the UMBILICUS. It is normally converted into a fibrous cord postnatally. When the canal fails to be filled and remains open (patent urachus), urine leaks through the umbilicus.
Recording of regional electrophysiological information by analysis of surface potentials to give a complete picture of the effects of the currents from the heart on the body surface. It has been applied to the diagnosis of old inferior myocardial infarction, localization of the bypass pathway in Wolff-Parkinson-White syndrome, recognition of ventricular hypertrophy, estimation of the size of a myocardial infarct, and the effects of different interventions designed to reduce infarct size. The limiting factor at present is the complexity of the recording and analysis, which requires 100 or more electrodes, sophisticated instrumentation, and dedicated personnel. (Braunwald, Heart Disease, 4th ed)