Percutaneous Balloon Plasty for Thoracic Duct Occlusion in a Patient with Chylothorax and Chylous Ascites

Cardiovasc Intervent Radiol. 2019 May;42(5):779-783. doi: 10.1007/s00270-018-02157-7. Epub 2019 Jan 7.

Abstract

A patient developed abdominal distension, dyspnea, and nausea due to chylothorax and chylous ascites 1 month after bruising her back. Lymphangiography was unable to identify the site of lymph leakage, and lymphatic duct embolization was impractical. However, lymphangiography showed occlusion of the thoracic duct. Thus, balloon plasty was performed to restore the patency of the thoracic duct, and the chylothorax and chylous ascites improved. Although embolization of the thoracic or lymphatic ducts has been reported as a treatment for lymphorrhea, it is impractical if the lymphatic duct responsible for leakage cannot be identified. In such a case, balloon plasty of the occluded thoracic duct to lower the pressure in the peripheral lymphatic ducts was successfully performed.

Keywords: Balloon; Chylothorax; Chylous ascites; Lymphangiography; Thoracic duct plasty.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon / methods*
  • Chylothorax / complications*
  • Chylothorax / diagnostic imaging
  • Chylothorax / therapy
  • Chylous Ascites / complications*
  • Chylous Ascites / diagnostic imaging
  • Chylous Ascites / therapy
  • Female
  • Humans
  • Lymphography
  • Thoracic Duct / diagnostic imaging
  • Thoracic Duct / pathology*
  • Treatment Outcome