Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Br J Radiol. 2022 Sep 1;95(1137):20211270. doi: 10.1259/bjr.20211270. Epub 2022 Jul 27.
To assess the effectiveness of intranodal lymphangiography using ethiodised oil (Lipiodol; Guerbet Japan, Tokyo, Japan) for the treatment of refractory cases of chylothorax and chylous ascites in the paediatric population.
Between 2016 and 2020, eight children having chyle leak resistant to conservative management underwent intranodal lymphangiography using lipiodol injection. After ethical approval by the Institutional Review Board, these patients' data were retrospectively analysed. Technical success was defined by opacification of inguinal and retroperitoneal lymphatics while injection on fluoroscopy. Clinical success was defined as progressively decreasing drain output and eventual cessation of output within a week after the procedure. Long-term follow up was done as feasible.
Technical success was achieved in all the patients. Complete cessation of drain output was noted within 1 week of procedure in all patients indicating clinical success. One patient had recurrence of chylous leakage after an interval of 1 month and intranodal lymphangiography was repeated for that patient. The child had technical as well as clinical success after the repeat procedure. Hence a total of 9 procedures were performed in 8 patients.
Intranodal lymphangiography may prove to be a valuable minimally invasive therapeutic tool in cases of refractory chylous leakage in paediatric patients with minimal risk of complications.
Intranodal lymphangiography using lipiodol may prove to be a minimally invasive alternative in paediatric patients with refractory lymphatic leaks.
评估使用碘化油（Lipiodol；Guerbet Japan，东京，日本）进行淋巴结内淋巴造影术治疗儿科难治性乳糜胸和乳糜性腹水的效果。
2016 年至 2020 年间，8 例乳糜漏经保守治疗无效的患儿接受了淋巴结内淋巴造影术，使用碘化油注射。在机构审查委员会的伦理批准后，回顾性分析了这些患者的数据。技术成功定义为腹股沟和腹膜后淋巴管在透视下显影的同时进行注射。临床成功定义为引流管引流量逐渐减少，并在术后 1 周内最终停止引流。可行的情况下进行长期随访。
所有患者均获得技术成功。所有患者在术后 1 周内均停止引流，表明临床成功。1 例患者在 1 个月后复发乳糜漏，对该患者重复进行淋巴结内淋巴造影术。该患者在重复操作后获得了技术和临床成功。因此，8 例患者共进行了 9 次操作。
在儿科难治性乳糜漏患者中，淋巴结内淋巴造影术可能是一种有价值的微创治疗工具，并发症风险极小。
使用碘化油进行淋巴结内淋巴造影术可能是一种微创替代方法，适用于难治性淋巴漏的儿科患者。
