Background

Chylothorax is a relatively rare complication of esophagectomy but can lead to fatal conditions. The aim of this report was to present a case of lymphangiography from the para-aortic lymph node (PALN) under computed tomography (CT) guidance, which could be an alternative modality to ultrasound sonography from the groin.

Case presentation

A 58-year-old man was diagnosed as having postoperative chylothorax after esophagectomy following neoadjuvant chemotherapy. As the pleural effusion did not improve, intranodal lipiodol lymphangiography from the inguinal lymph node was performed but was unsuccessful. Therefore, CT-guided lymphangiography from the left PALN was performed, and the pleural effusion drainage significantly disappeared.

Conclusions

CT-guided lipiodol lymphangiography from the PALN for chylothorax after esophagectomy was safe and thus can be considered an alternative treatment option to ultrasonography-guided intranodal lymphangiography. The flexible use of CT and ultrasonography for lymphangiography may improve the treatment outcomes of chylothorax after esophagectomy.

中文翻译：

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主动脉旁淋巴结计算机断层扫描引导下的淋巴管造影：食管切除术后乳糜胸的有用方法

背景

乳糜胸是食管切除术相对罕见的并发症，但可能导致致命的情况。本报告的目的是介绍一例在计算机断层扫描 (CT) 引导下从主动脉旁淋巴结 (PALN) 进行淋巴管造影的病例，这可能是腹股沟超声检查的替代方法。

案例展示

一名 58 岁男性在新辅助化疗后食管切除术后被诊断为术后乳糜胸。由于胸腔积液没有改善，进行了腹股沟淋巴结的结内碘油淋巴管造影，但未成功。因此，从左侧PALN进行CT引导下的淋巴管造影，胸腔积液引流明显消失。

结论

食管切除术后来自 PALN 的 CT 引导的碘油淋巴管造影对乳糜胸是安全的，因此可以考虑作为超声引导的结内淋巴管造影的替代治疗选择。CT和超声在淋巴管造影中的灵活应用可能会改善食管切除术后乳糜胸的治疗效果。