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A 49-year-old female presented to the emergency department after multiple stab injuries. Bilateral thoracostomy was performed due to a right hemopneumothorax and a left pneumothorax without tracheoesophageal and vascular injury. On admission day 4, a significant amount of milky fluid was collected in the drain after initiation of regular diet. Under suspicion of chylothorax, conservative management was initiated, but failed. Surgery was considered, but ruled out due to the patient's refusal. As an alternative, lymphangiography was performed, which resulted in decreased thoracic drainage and eventual removal of the chest tube. This is an unusual case of an isolated thoracic duct injury that was successful treated by closure of the duct after intranodal lymphangiography.
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http://dx.doi.org/10.3978/j.issn.2072-1439.2015.10.35 | DOI Listing |
Eur Radiol
August 2025
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Objective: To demonstrate the optimized protocol for CT lymphangiography (CTL) and describe its performance in pediatric and adult patients with suspected thoracic duct injury.
Materials And Methods: Patients with suspected thoracic duct injury who underwent either CTL or dynamic contrast-enhanced MR lymphangiography (DCMRL) between August 2017 and July 2024 at a tertiary referral center were retrospectively evaluated. CTL and DCMRL were performed using inguinal lymph node cannulation.
J Vasc Interv Radiol
August 2025
Assistant Professor of Anaesthesia, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,. Electronic address:
Purpose: To investigate whether anesthesia type (sedation vs. general anesthesia) or α adrenergic agonist vasoconstrictor administration is associated with faster intralymphatic contrast transit during intranodal lymphangiography in an effort to identify modifiable nonprocedural factors that may reduce procedure duration.
Methods: This retrospective observational study reviewed intranodal lymphangiography from two academic hospitals (2015 - 2022).
Cureus
June 2025
Department of Cardiology, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND.
Chyluria, the passage of chyle-laden lymph into urine, is most frequently linked to filarial infection but may also occur in diverse nonparasitic settings. We describe a 43-year-old man with diabetes, hypertension, and rheumatic heart disease who was admitted with prolonged fever and dyspnea and found to have infective endocarditis. The patient developed persistent milky urine during hospitalization that was unresponsive to a high-protein, low-fat diet supplemented with medium-chain triglycerides.
View Article and Find Full Text PDFDiagnostics (Basel)
May 2025
Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China.
To investigate the diagnostic value of various lymphatic imaging techniques for thoracic duct (TD) outlet obstruction in patients with chylous leakage. A retrospective analysis was conducted on 23 patients with chylous leakage who were radiologically diagnosed with a TD outlet obstruction and underwent a TD exploration and reconstruction between January 2022 and February 2025. Non-enhanced magnetic resonance lymphangiography (MRL), Tc-DX lymphoscintigraphy, and intranodal lymphangiography were employed to detect abnormalities in the central lymphatic vessels.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
June 2025
Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
Purpose: This paper introduces a novel technique, cervical lymphangiogram, involving intranodal lymphangiogram through cervical lymph nodes. We will discuss our preliminary experience regarding the technique, safety, and applications, offering a promising approach to addressing central conducting duct opacification challenges.
Material And Methods: This retrospective study was IRB exempt.