Ginat D T, Sahler L G, Patel N, Saad W A, Waldman D L
Department of Imaging Sciences and Interventional Radiology, University of Rochester Medical Center, Rochester, New York, 14242, USA.
Lymphology. 2009 Sep;42(3):130-3.
Chylothorax is a rare complication of thoracic surgery. Lymphangiography has long been considered to be the standard of reference for diagnosis and post-treatment evaluation while the role of post-lymangiographic CT is debated. We report a case of chylothorax in a 68-year-old male following esophagogastrectomy for which conservative treatment and thoracic duct ligation failed. Lymphangiography performed after these attempts revealed persistent thoracic duct leakage into the right pleural space. Subsequent non-contrast CT and reformatted images clearly depicted the sources of leakage, and this documentation targeted direct percutaneous treatment. Unfortunately, the lack of access precluded the planned percutaneous CT-guided embolization of the thoracic duct. Nevertheless, this case suggests that post- lymphangiographic CT can serve as a value-added modality in the evaluation and potential treatment of chylothorax.
乳糜胸是胸外科手术的一种罕见并发症。长期以来，淋巴管造影一直被视为诊断和治疗后评估的参考标准，而淋巴管造影后CT的作用仍存在争议。我们报告一例68岁男性在食管胃切除术后发生乳糜胸的病例，该患者的保守治疗和胸导管结扎均失败。在这些尝试之后进行的淋巴管造影显示胸导管持续向右侧胸腔漏液。随后的非增强CT及重组图像清晰地显示了漏液的来源，这一记录为直接经皮治疗提供了目标。遗憾的是，由于无法进行穿刺，原计划的经皮CT引导下胸导管栓塞术未能实施。尽管如此，该病例表明淋巴管造影后CT在乳糜胸的评估和潜在治疗中可作为一种有价值的补充手段。
