Abstract
Thoracic duct injury is potential complication of neck surgeries, especially surgeries that include neck dissection. It can present as a lymphatic drainage at the wound site, chylous fistula, chylothorax, chylomediastinum, chylopericardium, lymphocele, persistent lymphorrhea, or secondary lymphedema. This complication is managed with intraoperative repair of the injury if recognized, conservative measures of dietary changes and octeriotide, thoracic duct embolization by interventional radiology, or surgical re-exploration of the wound with repair of the injury. This chapter describes a technique to selectively embolize the injured lymphatic branch of the thoracic duct utilizing coils and Onyx instead of embolizing the main duct. This technique eliminates the need for nodal or pedal lymphogram and thus saves time, effort, and reduces expense.
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