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Chinese Journal of Clinicians(Electronic Edition) ›› 2019, Vol. 13 ›› Issue (11): 817-821. doi: 10.3877/cma.j.issn.1674-0785.2019.11.004

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Lymphangiography for diagnosis and treatment of traumatic chylous leak: a preliminary report

Dingyi Liu1, Weimu Xia1,(), Jian Wang1, Qi Tang1, Yanfeng Zhou1, Jiashun Yu1, Wenmin Li1, Hongchao He2   

  1. 1. Department of Urology, Shanghai Punan Hospital, Shanghai 200125, China
    2. Department of Urology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200025, China
  • Received:2019-04-12 Online:2019-06-01 Published:2019-06-01
  • Contact: Weimu Xia
  • About author:
    Corresponding author: Xia Weimu, Email:

Abstract:

Objective

To investigate the diagnostic and therapeutic roles of lymphangiography in 13 patients with traumatic chylous fistula to improve the treatment of this disease.

Methods

Twelve cases of postoperative chylous leakage after initial conservative treatment for 5-14 days and one case of chylous leakage after chest compression injury treated at Shanghai Pudong Hospital from May 2008 to January 2019 were enrolled in this study. Unilateral dorsal foot lymphangiography was performed in all 13 cases before reoperation, and the treatment method was re-evaluated according to the results of lymphangiography.

Results

Chyle leakage was observed in eight cases according to dorsal foot lymphangiography, and five of them were cured by surgery. The other three cases with chyle leakage and four cases who failed to show chyle leakage were cured by conservative treatment (7-45 days), since chyle flow decreased significantly after lymphography. The case of chest compression injury who failed to show chylous leak had deteriorated disease after conservative treatment and died after reoperation.

Conclusion

The location of chylous leak can be determined by lymphangiography of the anterior foot back, which is conducive to improving the success rate of surgery. For patients with reduced chylous leak after lymphangiography, conservative treatment can be continued regardless of whether the chylous leak is confirmed or fails to be shown. It is difficult to achieve the ideal therapeutic effect because of the blindness of reoperation for patients who cannot clearly show chylous leak.

Key words: Chylous, Lymphangiography, Diagnosis, Treatment

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