title: Cervical chylous leakage following esophagectomy that was successfully treated by intranodal lipiodol lymphangiography: a case report.
abstract: BACKGROUND
  Chylous leakage is a well-known complication after esophagectomy, but cervical chylous leakage is relatively rare, and considerable controversy remains regarding the appropriate management strategies. We herein report a case of cervical chylous leakage treated successfully by lipiodol lymphangiography.
  
  
  METHODS
  The patient, a 70-year-old man with middle thoracic esophageal cancer, underwent radical esophagectomy with 3-field lymph node dissection and subsequently developed cervical chylous leakage. From the second postoperative day (POD2), the amount of fluid in the cervical drainage tube increased by 200-300 ml/day. We started octreotide (300 μg/day) on POD5 and etilefrine (120 mg/day) on the POD6. However, the amount of cervical discharge did not decrease. We performed lipiodol lymphangiography on POD8. Thereafter, the amount of cervical discharge finally began to decrease. We removed the drainage tube on POD13, and the patient was discharged from the hospital on POD23.
  
  
  CONCLUSIONS
  Our case suggests the clinical efficacy of lipiodol lymphangiography for cervical chylous leakage after esophagectomy.
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan. tamura.tatsuro@med.osaka-cu.ac.jp.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Departments of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima Hondori Miyakojimaku, Osaka, 534-0021, Japan.
authors.forename: Naoshi
authors.initials: N
authors.lastname: Kubo
authors.affiliation: Department of Diagnostic and Interventional Radiology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Departments of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima Hondori Miyakojimaku, Osaka, 534-0021, Japan.
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Sakurai
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyokawa
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Muguruma
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yashiro
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
authors.affiliation: Department of Surgical Oncology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
authors.forename: Masaichi
authors.initials: M
authors.lastname: Ohira
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell; D002913:Chyle; D003287:Contrast Media / Q000627:therapeutic use*; D004322:Drainage; D004938:Esophageal Neoplasms; D016629:Esophagectomy / Q000009:adverse effects*; D004998:Ethiodized Oil / Q000627:therapeutic use*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008220:Lymphography / Q000379:methods*; D008297:Male; D009333:Neck; D013897:Thoracic Duct / Q000293:injuries
chemical_list: D003287:Contrast Media; D004998:Ethiodized Oil
keywords: Cervical chylous leakage; Esophageal cancer; Lipiodol lymphangiography