A patient developed abdominal distension, dyspnea, and nausea due to chylothorax and chylous ascites 1 month after bruising her back. Lymphangiography was unable to identify the site of lymph leakage, and lymphatic duct embolization was impractical. However, lymphangiography showed occlusion of the thoracic duct. Thus, balloon plasty was performed to restore the patency of the thoracic duct, and the chylothorax and chylous ascites improved. Although embolization of the thoracic or lymphatic ducts has been reported as a treatment for lymphorrhea, it is impractical if the lymphatic duct responsible for leakage cannot be identified. In such a case, balloon plasty of the occluded thoracic duct to lower the pressure in the peripheral lymphatic ducts was successfully performed.
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Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
This case report was approved by our institutional review board, and the requirement to obtain informed consent for inclusion in this study was waived. Informed consent for percutaneous balloon thoracic duct plasty was obtained from the patient before the procedure.
Itkin M, Kucharczuk JC, Kwak A, Trerotola SO, Kaiser LR. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: experience in 109 patients. J Thorac Cardiovasc Surg. 2010;139(3):584–9 discussion 9–90, Epub 2010/01/01.CrossRefGoogle Scholar
Nadolski GJ, Itkin M. Thoracic duct embolization for nontraumatic chylous effusion: experience in 34 patients. Chest. 2013;143(1):158–63 Epub 2012/07/17.CrossRefGoogle Scholar
Baek Y, Won JH, Chang SJ, Ryu HS, Song SY, Yim B, et al. Lymphatic embolization for the treatment of pelvic lymphoceles: preliminary experience in five patients. J Vasc Interv Radiol. 2016;27(8):1170–6.CrossRefGoogle Scholar
Hur S, Shin JH, Lee IJ, Min SK, Min SI, Ahn S, et al. Early experience in the management of postoperative lymphatic leakage using lipiodol lymphangiography and adjunctive glue embolization. J Vasc Interv Radiol. 2016;27(8):1177–86 e1 Epub 2016/07/01.CrossRefGoogle Scholar
Nadolski GJ, Chauhan NR, Itkin M. Lymphangiography and lymphatic embolization for the treatment of refractory chylous ascites. Cardiovasc Intervent Radiol. 2018;41(3):415–23 Epub 2017/12/15.CrossRefGoogle Scholar
Laslett D, Trerotola SO, Itkin M. Delayed complications following technically successful thoracic duct embolization. J Vasc Interv Radiol. 2012;23(1):76–9 Epub 2011/11/26.CrossRefGoogle Scholar
Dori Y, Keller MS, Rome JJ, Gillespie MJ, Glatz AC, Dodds K, et al. Percutaneous lymphatic embolization of abnormal pulmonary lymphatic flow as treatment of plastic bronchitis in patients with congenital heart disease. Circulation. 2016;133(12):1160–70 Epub 2016/02/13.CrossRefGoogle Scholar
Pillay TG, Singh B. A review of traumatic chylothorax. Injury. 2016;47(3):545–50 Epub 2016/01/19.CrossRefGoogle Scholar
Apostolakis E, Akinosoglou K, Koletsis E, Dougenis D. Traumatic chylothorax following blunt thoracic trauma: two conservatively treated cases. J Cardiac Surg. 2009;24(2):220–2 Epub 2009/03/10.CrossRefGoogle Scholar