Tatekawa Yukihiro, Tsuzuki Yukihiro, Fukuzato Yoshimitsu
Department of Pediatric Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Shimajiri-gun, Okinawa 901-1193, Japan.
J Surg Case Rep. 2024 Dec 19;2024(12):rjae799. doi: 10.1093/jscr/rjae799. eCollection 2024 Dec.
The Denver shunt is used for persistent chylothorax as a pleuroperitoneal shunt. Insertion of a Denver shunt was attempted in the current case involving a 3-year-old male with a refractory right cervical mediastinal lymphangioma. He was medicated with Eppikajutsuto® (0.65 g/kg) and underwent a Denver shunt for volume reduction of the cervical cyst to prevent airway obstruction. However, revision surgery for hemorrhage in the lymphangioma revealed that the tip of the shunt catheter had penetrated the cyst wall. The rounded tip of the catheter was placed back into the cyst. Oral administration of sirolimus (1 mg) was added. The Denver shunt was removed due to a catheter infection and administration of sirolimus was temporarily stopped because of an elevated blood concentration. Six months postoperatively from the third operation, neck swelling was negligible and radiologic findings showed complete regression of the lymphangioma.
丹佛分流管作为一种胸膜腹膜分流装置，用于治疗持续性乳糜胸。在当前这个病例中，一名3岁男性患有难治性右颈纵隔淋巴管瘤，尝试插入丹佛分流管。给他服用了“エッピカジュツト”（0.65克/千克），并接受了丹佛分流术以减少颈部囊肿的体积，防止气道阻塞。然而，淋巴管瘤出血的翻修手术显示分流导管尖端穿透了囊肿壁。将导管的圆形尖端放回囊肿内。加用了西罗莫司（1毫克）口服。由于导管感染，移除了丹佛分流管，并且由于血液浓度升高，暂时停用了西罗莫司。第三次手术后六个月，颈部肿胀不明显，影像学检查结果显示淋巴管瘤完全消退。
