Lymphangiography as therapeutic management of chylothorax

Abstract

Chylothorax is a rare post surgical complication. It is often initially treated using conservative management such as chest drain insertion, a medium chain triglyceride diet, total parenteral nutrition and somatostatin analogues. Lymphangiography has been used in the past, mainly to identify the site of a chyle leak, but there have been reports where lymphangiography has been therapeutic in the management of chylothorax and has led to resolution of the chyle leak. This paper describes the case of a 15-year-old male who presented with a post-operative chylothorax. He was initially managed conservatively, which failed to stop the chyle leak and lymphangiography was performed. Imaging confirmed that lymphangiography was successful in stopping the chyle leak, leading to resolution of the chylothorax. This case demonstrates that lymphangiography can be used as a therapeutic measure in the management of a chylothorax.