title: Traumatic laceration of the cisterna chyli treated by lymphangiography and percutaneous embolization.
abstract: Lymphangiography and percutaneous embolization has been described for the treatment of thoracic duct injury, usually occurring in the postsurgical period. We report a case of a traumatic gunshot-induced massive chylothorax. Inguinal lymphangiogram was performed demonstrating the site of injury at the cisterna chyli. The cisterna chyli was successfully accessed via a percutaneous approach, and embolization was performed. Chylothorax immediately resolved after two rounds of embolization. Although lymphangiography has been traditionally challenging and cumbersome, because of the need for pedal lymph access, the recent use of inguinal lymphangiography has made this technique more practical. Techniques used for embolization of the thoracic duct may be applied to the cisterna chyli, which is much more challenging to treat surgically.
authors.affiliation: Section of Interventional Radiology, Department of Radiology, University of Washington and Harborview Medical Center, 1959 NE Pacific Street, Seattle, WA, 98195, USA, sallison@uw.edu.
authors.forename: Stephen
authors.initials: S
authors.lastname: Allison
authors.forename: Matthew
authors.initials: M
authors.lastname: Rainey
authors.forename: Shahram
authors.initials: S
authors.lastname: Aarabi
authors.forename: Siddharth A
authors.initials: SA
authors.lastname: Padia
mesh_terms: D002916:Chylothorax / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D004998:Ethiodized Oil / Q000008:administration & dosage; D005471:Fluoroscopy; D006801:Humans; D022125:Lacerations / Q000628:therapy*; D008220:Lymphography / Q000379:methods*; D008297:Male; D013897:Thoracic Duct / Q000293:injuries*; D018084:Ultrasonography, Interventional; D014948:Wounds, Gunshot / Q000150:complications / Q000628:therapy*; D055815:Young Adult
chemical_list: D004998:Ethiodized Oil