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Lymphangiography and Lymphatic Embolization for the Treatment of Refractory Chylous Ascites.
- Source :
-
Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2018 Mar; Vol. 41 (3), pp. 415-423. Date of Electronic Publication: 2017 Dec 13. - Publication Year :
- 2018
-
Abstract
- Purpose: Assess the effectiveness of conventional lymphangiography, MR lymphangiography, and lymphatic embolization for the diagnosis and treatment of refractory chylous ascites.<br />Materials and Methods: A retrospective review of 31 patients (M/F:16/15, average age 52) who presented for the management of refractory chylous ascites was conducted to assess the diagnostic value of conventional and MR lymphangiography and outcome of lymphatic embolization.<br />Results: Of the total 31 patients, 25 presented with chylous ascites secondary to iatrogenic trauma and six patients with a non-traumatic etiology. All patients underwent conventional lymphangiography and nine underwent MR lymphangiogram. The lymphatic leak was visualized in 17/31 (55%) of the patients (15 of which were traumatic) and in 7/9 MR lymphangiograms (six traumatic and one non-traumatic). Embolization with n-BCA glue and/or coils of the leak was performed in 11 of the 17 patients whose leak was identified (65%) with resolution of chylous ascites in 9/11 (82%) patients. Lymphangiogram alone was curative in 7/20 (35%) patients. Overall, 16/31 patients (52%) had clinical resolution of ascites. Ascites resolved in 13/17 (76%) patients in whom the site of leak could be identified compared to 3/14 (21%) of patients in whom the site of leak could not be identified (p = 0.0038).<br />Conclusions: Lymphangiography and embolization can be used to treat chylous ascites. Identification of the site of leak is associated with significantly greater rate of clinical success compared to those whose site could not be identified.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Female
Humans
Lymphatic Vessels diagnostic imaging
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Young Adult
Chylous Ascites diagnostic imaging
Chylous Ascites therapy
Embolization, Therapeutic methods
Lymphography methods
Magnetic Resonance Imaging methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-086X
- Volume :
- 41
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Cardiovascular and interventional radiology
- Publication Type :
- Academic Journal
- Accession number :
- 29238869
- Full Text :
- https://doi.org/10.1007/s00270-017-1856-1