A Case Report on the Management of Intractable Chyle Leakage after Left Neck Level V Lymph Node Biopsy
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Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic orlymphatic duct, is an uncommon complication of head and neck surgeries, which include neckdissection or thyroidectomy. A small amount of chyle leakage can be treated with conservativeapproaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of thewound and thoracic duct ligation via the chest or transabdominal thoracic duct embolizationcan be applied. Here, we report a case of intractable massive chyle leakage in a 78-year-oldmale after a left neck level V lymph node biopsy, which was not controlled after conservativemanagement and explorative surgery. Various treatment approaches were attempted and successfulmanagement of chyle leakage was ultimately achieved by thoracic duct embolization.
Abstract
Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic orlymphatic duct, is an uncommon complication of head and neck surgeries, which include neckdissection or thyroidectomy. A small amount of chyle leakage can be treated with conservativeapproaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of thewound and thoracic duct ligation via the chest or transabdominal thoracic duct embolizationcan be applied. Here, we report a case of intractable massive chyle leakage in a 78-year-oldmale after a left neck level V lymph node biopsy, which was not controlled after conservativemanagement and explorative surgery. Various treatment approaches were attempted and successfulmanagement of chyle leakage was ultimately achieved by thoracic duct embolization.
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