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The use of indocyanine green lymphography for the treatment of postoperative chylothorax with lipiodol lymphangiography in a 2-year-old child

The use of indocyanine green lymphography for the treatment of postoperative chylothorax with lipiodol lymphangiography in a 2-year-old child

Authors :
Motoi Kato
Koji Nomura
Yoshihiro Ko
Hiroo Kinami
Yutaka Tanami
Shoji Watanabe
Azusa Watanabe
Hiroki Utsunomiya
Ko Fujisawa
Source :
Journal of Pediatric Surgery Case Reports, Vol 23, Iss C, Pp 46-49 (2017)
Publication Year :
2017
Publisher :
Elsevier, 2017.

Abstract

Postoperative chylothorax in infants prolongs hospital stay and possibly causes developmental delay because of its conservative treatment including inanition. Several medical and surgical treatments may be applied, but none constitute the absolute solution. Treatment with lipiodol during lymphangiography for postoperative chylothorax has been reported to be highly effective and less invasive in adults. On the other hand, few cases have been reported in infants. We demonstrate successful blockage of chyle leakage with lipiodol injection through the inguinal lymph node in a 2-year-old infant. The patient had undergone on-pump coarctectomy and chylothorax developed soon after surgery. Several medical treatments were partially effective, but the chest tube could not be removed because sequential aspiration was required to maintain a normal respiratory status. With the patient under general anesthesia, lipiodol injection combined with indocyanine green (ICG) lymphography was performed. Lymphography combined with ICG significantly contributed not only to intraoperative detection of the inguinal lymph nodes but also to postoperative early detection of lymphedema caused by this procedure. This procedure required a simple maneuver and is probably applicable to other cases of traumatic chylothorax, such as after surgeries on the esophagus, trachea, or other components of the posterior mediastinum.

Details

Language :
English
ISSN :
22135766
Volume :
23
Issue :
C
Database :
Directory of Open Access Journals
Journal :
Journal of Pediatric Surgery Case Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.341a31407248338cdfc00afc743699
Document Type :
article
Full Text :
https://doi.org/10.1016/j.epsc.2017.06.005