Chyle leak: A rare complication post-hemithyroidectomy. Case report and review of literature

Abstract

Chyle leak post-thyroidectomy for a benign disease is a very rare complication. Nevertheless, head and neck surgeons should consider it in the differential diagnosis of neck swelling post-thyroidectomy.

Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies

“…Chyle leak (CL) from iatrogenic thoracic duct injury is a rare but serious complication of head and neck surgery that occurs in 0.5–1.4% of thyroidectomies [ 1 – 4 ] and 2–8% of neck dissections [ 5 – 8 ]. The variable anatomy and fragile composition of the thoracic duct render it prone to inadvertent injury.…”

Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer

“…[1][2][3] Most reported cases involve complete cervical neck dissection, 1,4-7 but a few surgeons have experienced chyle leakage in patients who underwent lobectomy without neck dissection. 8 If chyle leakage persists, it can cause severe electrolyte disturbance, protein loss, metabolic depletion, infection, and skin necrosis. [9][10][11] Conservative management is usually chosen as the initial treatment for chyle leakage, and surgical management is performed when conservative management is ineffective.…”

“…Chyle leakage is an uncommon complication of thyroid surgery and cervical node dissection, with an incidence of 0.5%‐8.3% depending on the extent of surgery . Most reported cases involve complete cervical neck dissection, but a few surgeons have experienced chyle leakage in patients who underwent lobectomy without neck dissection . If chyle leakage persists, it can cause severe electrolyte disturbance, protein loss, metabolic depletion, infection, and skin necrosis …”

Chyloma formation after anterior cervical disc fusion

“…During head and neck surgery, chyle leak from iatrogenic thoracic duct injury is a rare but serious complication that occurs in 0.5%‐1.4% of thyroidectomies 6‐10 and 2%‐8% of neck dissections 2,6,11‐13 . However, it has only been reported postoperatively twice before following an ACDF 14 .…”