Thoracic duct injury due to left subclavicular vein catheterization: A new conservative approach to a chyle fistula using biological glue

Anestis, Ninos; Farazi-Chongouki, Christos; Ioannis, Pougouras; Christos, Iordanou; Lampros, Palivos; Stephanos, Pierrakakis

doi:10.1016/j.ijscr.2012.03.021

Cited by 17 publications

(11 citation statements)

References 13 publications

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“…Cyanoacrylate adhesives, fibrin glue [ 63 – 65 ], and polyglactin (Vicryl) mesh [ 64 ] have been placed at the time of surgery, with success, for controlling visible CL.…”

Section: Treatment Options For Chyle Leaksmentioning

confidence: 99%

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

Delaney

Shi

Shokrani

et al. 2017

International Journal of Otolaryngology

119

147

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Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body. Chyle extravasation can result in delayed wound healing, dehydration, malnutrition, electrolyte disturbances, and immunosuppression. Prompt identification and treatment of a chyle leak are essential for optimal surgical outcome. In this article we will review the current treatment options for iatrogenic cervical chyle leaks.

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“…Cyanoacrylate adhesives, fibrin glue [ 63 – 65 ], and polyglactin (Vicryl) mesh [ 64 ] have been placed at the time of surgery, with success, for controlling visible CL.…”

Section: Treatment Options For Chyle Leaksmentioning

confidence: 99%

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

Delaney

Shi

Shokrani

et al. 2017

International Journal of Otolaryngology

119

147

View full text Add to dashboard Cite

show abstract

“…In this case, the patient likely experienced primary injuries to the thoracic duct, and the injury sites contained a considerable amount of necrotic tissues. Therefore, we could not perform a ligation procedure [ 4 ] or utilize biological glue to seal the chylous fistula site [ 5 ] due to the high risk of failure. As a result, we initially selected conservative treatment to reduce the amount of chylous fistula in the early treatment stage [ 4 , 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

et al. 2016

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Patient: Male, 32Final Diagnosis: Thoracic duct chylous fistulaSymptoms: FistulaMedication: —Clinical Procedure: A boneless muscle flap transplantatioSpecialty: —Objective:Rare diseaseBackground:As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest.Case Report:A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula.Conclusions:Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing.

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“…[9][10][11] Currently available adjuncts to open ligation of the TD include percutaneous embolization of coils, gelfoam, ethanol, BioGlue, and povidone-iodine injected directly into the injured TD. 12,13 As the incidence of esophageal resection for cancer has increased, we expect to experience chylothorax following robotic esophagectomy, transhiatal and open esophagectomy, 14 although no robotic or lap-assisted procedures resulted in chylothorax during this study period. The most common procedure resulting in chylothorax in this series was the IvorLewis (right thoracotomy-transabdominal) esophagectomy.…”

Section: Commentsmentioning

confidence: 94%

Percutaneous embolization of thoracic duct injury post-esophagectomy should be considered initial treatment for chylothorax before proceeding with open re-exploration

Marthaller¹,

Johnson²,

Pride³

et al. 2015

The American Journal of Surgery

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Thoracic duct injury due to left subclavicular vein catheterization: A new conservative approach to a chyle fistula using biological glue

Cited by 17 publications

References 13 publications

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

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

Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

Percutaneous embolization of thoracic duct injury post-esophagectomy should be considered initial treatment for chylothorax before proceeding with open re-exploration

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