Lymphoscintigraphy with single-photon emission computed tomography/computed tomography is useful for determining the site of chyle leakage after esophagectomy

Small Chyle Leak Localized on Lymphoscintigraphy with Single-Photon Emission Computed Tomography-Computed Tomography

Chylothorax refers to the accumulation of triglyceride-rich fluid (chyle) within the pleural space. We described a case of spontaneous chylothorax in an infant. Lymphoscintigraphy was performed with 99 m-Tc sulfur colloid which showed tracer accumulation into thoracic cavity, and single-photon emission computed tomography/CT (SPECT/CT) revealed leak in the thoracic duct at D8 vertebral level as the cause. We, thus, emphasize the role of lymphoscintigraphy with SPECT/CT in identification of cause and guiding the management of chylothorax, especially when surgical treatment is planned.

Lymphoscintigraphy combined with single-photon emission computed tomography-computed tomography (SPECT-CT): A very effective imaging approach for identification of the site of leak in postoperative chylothorax

Post operative chylothorax is a known complication of various thoracic surgeries. It needs identification of precise site of leak in the thoracic duct. Lymphosicintigraphy can identify chyle leak but cannot delineate exact site of leak. SPECT-CT is precise in anatomic localisation and hence SPECT-CT should be combined with every lymphoscintigraphy in evaluation of clinically suspected case of post operative chylothorax. We report such a case.

Postmastectomy/Axillary Node Dissection Chyloma: The Additional Value of SPECT/CT Lymphoscintigraphy

After mastectomy and axillary node dissection, chylous leakage is rare. However, considerable anatomical variation in the termination of the thoracic duct has been reported. Hence, during breast surgery, injury to the lateral terminating branch is not unlikely and might lead to retrograde chyle leak. Herein, we describe a patient who had a chylous leakage at her wound site after a left simple mastectomy and axillary node dissection and for whom lymphoscintigraphy with Tc-99m albumin nanocolloid was performed. In this case, additional hybrid single-photon emission computed tomography/computed tomography study was done, and has helped with the accurate identification of the chyle leakage site, thus aiding in surgical management.

Esophagectomy-related thoracic duct injury detected by lymphoscintigraphy with 99mTc-diethylenetriamine pentaacetic acid-human serum albumin: report of a case

Chylothorax is an uncommon but potentially life-threatening complication of esophagectomy. A 72-year-old man underwent thoracoscopy-assisted subtotal esophagectomy and reconstruction with a gastric tube, through a retrosternal route, after preoperative chemoradiotherapy. Chylothorax was detected after starting enteral feeding on postoperative day (POD) 7. Despite conservative therapy such as fasting, total parenteral nutrition, and octreotide administration, massive fluid drainage continued. On POD 19, lymphoscintigraphy with (99m)Tc-diethylenetriamine pentaacetic acid-human serum albumin (HSA-D) was performed and the site of leakage was detected at the level of the fourth thoracic vertebra. On POD 23, the thoracic duct was ligated, following which the volume of chylothorax decreased. Lymphoscintigraphy 12 days after the reoperation showed no leakage from the thoracic duct. We recommend lymphoscintigraphy with (99m)Tc-HSA-D for locating the chyle leakage site and helping decide about the operative indication.