title: Post-lymphangiographic computed tomography in chylothorax after esophagogastrectomy: a case report.
abstract: 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.
authors.affiliation: Department of Imaging Sciences and Interventional Radiology, University of Rochester Medical Center, Rochester, New York, 14242, USA. ginat01@gmail.com
authors.forename: D T
authors.initials: DT
authors.lastname: Ginat
authors.forename: L G
authors.initials: LG
authors.lastname: Sahler
authors.forename: N
authors.initials: N
authors.lastname: Patel
authors.forename: W A
authors.initials: WA
authors.lastname: Saad
authors.forename: D L
authors.initials: DL
authors.lastname: Waldman
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D002916:Chylothorax / Q000000981:diagnostic imaging* / Q000209:etiology*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008220:Lymphography / Q000379:methods*; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods*