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一名六岁女孩在Fontan相关乳糜胸后成功进行胸导管栓塞术:病例报告

Successful Thoracic Duct Embolization Following Fontan-Related Chylothorax in a Six-Year-Old Girl: A Case Report.

作者信息

Wandile Shailesh, Vagha Jayant D, Wazurkar Ajinkya, Lohiya Sham, Hinge Dinesh V, Javvaji Chaitanya Kumar, Khartade Prashant B, Nagrale Pooja B, Kommareddy Anirudh, Agrawal Prachita

机构信息

Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Interventional Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jun 23;16(6):e63005. doi: 10.7759/cureus.63005. eCollection 2024 Jun.

Abstract

Chylothorax is a severe complication following the Fontan procedure, causing significant morbidity and mortality due to nutritional depletion and fluid loss. We present a case involving a six-year-old girl with tricuspid atresia, atrial septal defect (ASD), ventricular septal defect (VSD), and severe pulmonary stenosis (PS), presenting with fever, non-productive cough, and increased work of breathing. Cyanosis was noted, improving with oxygen. Imaging revealed bilateral pleural effusion, with pleural fluid analysis confirming chylothorax. Despite normal laboratory reports, retrograde transvenous lymphangiography indicated thoracic duct leakage. The patient underwent successful thoracic duct embolization, resulting in the resolution of the effusion and stabilization of her condition. She was discharged in a stable state, with follow-up care.

摘要

乳糜胸是Fontan手术后的一种严重并发症,由于营养消耗和液体丢失导致显著的发病率和死亡率。我们报告一例病例,患者为一名6岁女孩,患有三尖瓣闭锁、房间隔缺损(ASD)、室间隔缺损(VSD)和严重肺动脉狭窄(PS),出现发热、干咳和呼吸做功增加。观察到有发绀,吸氧后有所改善。影像学检查显示双侧胸腔积液,胸腔积液分析确诊为乳糜胸。尽管实验室报告正常,但逆行经静脉淋巴管造影显示胸导管渗漏。患者接受了成功的胸导管栓塞术,胸腔积液消退,病情稳定。她出院时情况稳定,并接受随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1433/11272409/a4323c4c5779/cureus-0016-00000063005-i01.jpg

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