title: Use of computed tomography-lymphangiography with direct injection of water-soluble contrast medium to identify the origin of chylous ascites.
abstract: Contrast lymphangiography is a useful technique to determine the site of lymphatic leakage in the patient with chylous ascites. Conventional lymphangiography with lipid-soluble contrast material carries the disadvantage of complications, such as oil emboli and lymphedema. The authors report a successful case of computed tomography (CT)-lymphangiography with direct injection of water-soluble contrast medium into a lower limb lymphatic vessel to determine the site of lymphatic leakage in a pediatric patient with refractory primary chylous ascites. The patient subsequently underwent laparoscopic ligation of the leaking site and recovered well. This novel technique offers superior potential for preoperative assessment and the planning of laparoscopic repair.
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: kohei815@clin.medic.mie-u.ac.jp.
authors.forename: Kohei
authors.initials: K
authors.lastname: Otake
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Koike
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D002915:Chylous Ascites / Q000000981:diagnostic imaging* / Q000209:etiology; D003287:Contrast Media; D006801:Humans; D010535:Laparoscopy; D042601:Lymphatic Vessels; D008209:Lymphedema; D008220:Lymphography; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media