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Case Reports
. 2020 Sep 15;15(11):2353-2357.
doi: 10.1016/j.radcr.2020.09.009. eCollection 2020 Nov.

Intrahepatic lymphatic channel sclerotic embolization for treatment of postoperative lymphatic ascites: a report of 3 cases

Ngoc Cuong Nguyen  1 , Masanori Inoue  2 , Tuan Linh Le  1 , Hong Canh Pham  1 , Hong Son Trinh  3 , Duc Huan Pham  4 , Hoang Nguyen  4 , Anh Tuan Tran  5 , Dang Luu Vu  5 , Natali Delphine  6
Affiliations
Case Reports

Intrahepatic lymphatic channel sclerotic embolization for treatment of postoperative lymphatic ascites: a report of 3 cases

Ngoc Cuong Nguyen et al. Radiol Case Rep. .

Abstract

Postoperative hepatic lymphorrhea is extremely rare and there is no standard treatment for this condition. We report the cases of 3 men, 32-, 56-, and 37-year-old, with postoperative hepatic lymphorrhea, which was refractory to conservative treatment. Transhepatic lymphangiography allowed locating the lymphatic leak and treating it with hepatic lymphatic vessels injection of foam sclerotic agent. This technique seems efficient and safe.

Keywords: Lymphatic embolization; Lymphorrhea; Percutaneous transhepatic lymphangiography.

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Figures

Fig. 1 –
Fig. 1
Case 1. Panel A: MRI lymphangiography showing normal thoracic duct and no extravasation of contrast. Panel B and C: Transhepatic lymphangiography showing an extravasation of contrast at the liver hilum (arrow). No contrast extravasation was seen when the left hepatic lymphatic channel was opacified. Panel D: Noncontrast CT scanner just after the procedure revealing presence of contrast in the peritoneum.
Fig. 2 –
Fig. 2
Case 2. Panel A: Transhepatic lymphangiography showing no abnormality. Panel B: Noncontrast abdominal CT-scan just after lymphangiography showing presence of intraperitoneal contrast.
Fig. 3 –
Fig. 3
Case 3 Panel A: Transhepatic lymphangiography showing extravasation of contrast into the abdomen (arrow). Panel B: Conbeam CT was done after injecting foam, showing presence of air bubbles in lymphatic vessels at the hepatic hilum and lymphatic vessels retroperitoneal due to reflux (in the circle).
See this image and copyright information in PMC

References

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