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<p>The occurrence of isolated (without accompanying chylothorax) chylous ascites after a VATS-esophagectomy is never documented in literature yet. We present a case of a 64-year-old patient who underwent a VATS esophagectomy for carcinoma esophagus and developed such a complication. We usually clip the thoracic duct in mediastinum intraoperatively. Therefore, the leak was unlikely to resolve conservatively as the distal passage of lymph was blocked and the leak site was under constant retrograde pressure. Hence, it was essential to intervene quickly to prevent nutritional deficits in patients by prolonging the conservative trial. We identified the source of the leak at the cisterna chyli through lymphangiography. After evaluating the situation, we decided to embolize the cisterna chyli under interventional radiology (IR) guidance. As the cases reported for cisterna chyli direct embolization are none in literature, this opens newer arenas in interventional radiology for such specific case management.</p>

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 A Rare Case of Cisterna Chyli Direct Embolization for Chylous Ascites (Without Chylothorax) Post-VATS Esophagectomy

  • 期刊论文

  • 发表日期：

    2025年7月24日

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  • Dency S. Hansalia,
  • Tarun Kumar,
  • Apurv Veer Sharma,
  • Satya Vijay Chigurupati

摘要

The occurrence of isolated (without accompanying chylothorax) chylous ascites after a VATS-esophagectomy is never documented in literature yet. We present a case of a 64-year-old patient who underwent a VATS esophagectomy for carcinoma esophagus and developed such a complication. We usually clip the thoracic duct in mediastinum intraoperatively. Therefore, the leak was unlikely to resolve conservatively as the distal passage of lymph was blocked and the leak site was under constant retrograde pressure. Hence, it was essential to intervene quickly to prevent nutritional deficits in patients by prolonging the conservative trial. We identified the source of the leak at the cisterna chyli through lymphangiography. After evaluating the situation, we decided to embolize the cisterna chyli under interventional radiology (IR) guidance. As the cases reported for cisterna chyli direct embolization are none in literature, this opens newer arenas in interventional radiology for such specific case management.