CT-guided injection of N-butyl cyanoacrylate glue for treatment of chylous leak after aorto-mesenteric bypass

Cardiovasc Intervent Radiol. 2014 Aug;37(4):1103-6. doi: 10.1007/s00270-013-0811-z. Epub 2013 Dec 7.

Abstract

Lymphangiography and thoracic duct embolization are well-described techniques for the diagnosis and treatment of thoracic lymphatic leaks refractory to conservative treatment. However, thoracic duct embolization is not an option in patients with abdominal chylous leaks. The present report describes a 68-year-old man who underwent an aortomesenteric bypass complicated by a high-output postoperative chylothorax (>2,000 ml/day) and chylous ascites (>7,000 ml/paracentesis). Ultrasound-guided intranodal lymphangiography demonstrated a retroperitoneal lymphatic leak tracking along the vascular graft into the peritoneal cavity. Computed tomography-guided lymphatic duct occlusion with N-butyl cyanoacrylate glue was performed, resulting in successful treatment of both chylothorax and chylous ascites.

Publication types

  • Case Reports

MeSH terms

  • Adhesives / therapeutic use*
  • Aged
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / surgery*
  • Chylothorax / diagnostic imaging
  • Chylothorax / etiology
  • Chylothorax / therapy*
  • Contrast Media
  • Enbucrilate / therapeutic use*
  • Ethiodized Oil
  • Humans
  • Lymphography
  • Male
  • Mesenteric Vascular Occlusion / diagnostic imaging
  • Mesenteric Vascular Occlusion / surgery*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Radiography, Interventional*
  • Tomography, X-Ray Computed*
  • Ultrasonography, Interventional

Substances

  • Adhesives
  • Contrast Media
  • Ethiodized Oil
  • Enbucrilate