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Case Reports
. 2024 Jul 6;16(7):e63981.
doi: 10.7759/cureus.63981. eCollection 2024 Jul.

Pediatric Chylothorax Treated With Lymphangiography and Thoracic Duct Embolization: A Case Report

Harneet Sangha  1 , Nathan G Savolainen  1 , Douglas A Murrey  2 , Jason S Vergnani  2
Affiliations
Case Reports

Pediatric Chylothorax Treated With Lymphangiography and Thoracic Duct Embolization: A Case Report

Harneet Sangha et al. Cureus. .

Abstract

A chylothorax, the accumulation of lymphatic fluid in the pleural space, may occur for a variety of reasons. It is commonly seen in adults post-thoracic surgery. We present the case of a seven-month-old girl with a right-sided chylothorax in the setting of non-accidental trauma. Treatment options for a chylothorax include surgical ligation of the thoracic duct or, as in this case, a minimally invasive procedure performed by interventional radiology known as lymphangiography with thoracic duct embolization. This case highlights interventional radiologists' ability to treat complex lymphatic pathologies effectively with minimally invasive techniques.

Keywords: chylothorax; interventional radiology; lymphangiogram; thoracic duct; thoracic duct embolization.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest abdomen radiograph showing near-complete opacification of the right hemithorax concerning for a large pleural effusion in addition to a periosteal reaction of the left ribs and the proximal right humerus suspicious for subacute fractures and concerning for non-accidental trauma.
Figure 2
Figure 2. Close-up of the periosteal reaction.
Figure 3
Figure 3. Lymphangiogram showing the injection of Lipiodol into bilateral inguinal lymph nodes with antegrade flow through pelvic lymphatic channels.
Figure 4
Figure 4. Fluoroscopic image showing the continued flow of Lipiodol, which is now accumulating in the cisterna chyli near the right aspect of the T12 vertebral body.
Figure 5
Figure 5. Fluoroscopic spot image showing liquid embolic throughout the thoracic duct in addition to the accumulation of Lipiodol in the dependent right pleural space.
Figure 6
Figure 6. Coronal reformat of cone beam CT showing liquid embolic in the thoracic duct.
See this image and copyright information in PMC

References

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