Presentation
We present a simple technique for the treatment of chronic thoracic duct fistula where other procedures have failed. After identification and ligation of the duct, the area is covered with the clavicular head of the sternocleidomastoid muscle. [ncbi.nlm.nih.gov]
The contributors in this book present some components of immunological knowledge which relate to the present and the possible future practice of surgery. [books.google.com]
This promising trend is supported by the present case report of a chyle leak occurring after total thyroidectomy with central and lateral neck dissection for a papillary carcinoma, which was treated successfully without immediate or distant sequelae. [ingentaconnect.com]
On the first day post-op, the patient presented a high volume of discharge through the surgical drain tube (550 ml) that was chylous in appearance. [elsevier.es]
Chylothorax is even less frequent, and can exceptionally present bilaterally. [archbronconeumol.org]
Respiratoric
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Pleural Effusion
Logistic regression models were used to determine the risk factors for pleural effusion. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for pleural effusion were reported. [journals.plos.org]
effusion (most common on the left). [radiopaedia.org]
Clinical significance [ edit ] A chyle fistula occurs when defect(s) of lymphatic vessel(s) result in leakage of lymphatic fluid, typically accumulating in the thoracic (pleural) or abdominal (peritoneal) cavities, [2] leading to a chylous pleural effusion [en.wikipedia.org]
Roentgenogram of the chest and abdomen were suggestive of right-sided pleural effusion and ascites. Chromo-somal study was normal. The pleural and peritoneal aspirates drew sterile, acellular milky fluid (chyle). [indianpediatrics.net]
Gastrointestinal
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Chronic Diarrhea
Long-term complications after this technique appear in 14.3% of patients, the most frequent of which are chronic diarrhea and edema of the lower extremities. 9 In our case, the transcervical retrograde approach of the TD enabled us to locate the lesion [elsevier.es]
Musculoskeletal
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Arthritis
The National Institutes of Health (NIH), especially the Kidney, Urology, and Hematology Division of the National Institutes of Arthritis, Diabetes, and Digestive and Kidney Diseases (NIADDK), supports a sizable research program that bears on chronic renal [books.google.com]
Face, Head & Neck
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Neck Mass
Definition / general The most common developmental anomaly of thyroid gland, and the most common congenital neck mass Midline neck developmental anomaly due to persistence and cystic dilation of thyroglossal duct Thyroglossal duct (TGD) is the embryonic [pathologyoutlines.com]
Workup
Serum
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Hyponatremia
Although the most serious complications appear when this lesion occurs in the thorax, typically during esophagectomy, cervical lesions also have associated postoperative morbidity, including nutritional complications (malnutrition, hypoproteinemia, hyponatremia [elsevier.es]
Hypoproteinemia Hyponatremia Hypochloremia Dehydration Emaciation Lymphocytopenia and immunosupression Pleural effusion - chylothorax Wound problems - infection, suture breakdown, hemorrhage Chylopharyngeal fistula Peripheral edema [slideshare.net]
Hyponatremia (serum sodium concentration DISCUSSION The primary aim of the present study was to investigate whether postoperative administration of octreotide would reduce postoperative drainage volume. [e-ceo.org]
Pleura
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Pleural Effusion
Logistic regression models were used to determine the risk factors for pleural effusion. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for pleural effusion were reported. [journals.plos.org]
effusion (most common on the left). [radiopaedia.org]
Clinical significance [ edit ] A chyle fistula occurs when defect(s) of lymphatic vessel(s) result in leakage of lymphatic fluid, typically accumulating in the thoracic (pleural) or abdominal (peritoneal) cavities, [2] leading to a chylous pleural effusion [en.wikipedia.org]
Roentgenogram of the chest and abdomen were suggestive of right-sided pleural effusion and ascites. Chromo-somal study was normal. The pleural and peritoneal aspirates drew sterile, acellular milky fluid (chyle). [indianpediatrics.net]
Treatment
Treatment with a somatostatin analog resulted in an immediate attenuation of drainage and subsequent closure of the fistula after 16 days of treatment. [ncbi.nlm.nih.gov]
The escalating costs of the ESRD program are attributed to the increasing number of patients requiring treatment and have focused concerns of the United States Government, both Congress and the administration, on ESRD. [books.google.com]
Shirai T, Amano J, Takabe K: Thoracoscopic diagnosis and treatment of chylothorax after pneumonectomy. Ann Thorac Surg 1991;52:306–307. [karger.com]
Although there is no consensus about the standard treatment for this type of lesions, most authors recommend an initial conservative treatment, which usually consists of a low-fat diet with medium-chain triglyceride supplements and somatostatin analogs [elsevier.es]
Prognosis
Chest tube drainage treatment was usually successful, and the prognosis was good. [journals.plos.org]
Drugs Uremia SLE/RA Venous Hydralazine Scleroderma Arterial Procainamide Vasculitidies Chylous Minoxidil Myxedema XRT Pericardial Effusion - Uremia Once regarded as final event before death Prevalence 1954 - 51% 1980 - 10% Dialysis dramatically improved prognosis [radiology.vcu.edu]
In general, chylous ascites and chylothorax secondary to traumatic injury during vascular reconstruction carry a better prognosis than the same conditions occurring secondary to underlying neoplasia. [emedicine.medscape.com]
[…] potentially can detect functioning thyroid tissue in TGD ( Thyroid 2007;17:341 ) Radiology images Images hosted on PathOut server: Contributed by Ayana Suzuki, Cytotechnologist, Japan: Large cyst Images hosted on other servers: Prognostic factors Excellent prognosis [pathologyoutlines.com]
The prognosis remains serious, although the frequency and mortality of ARDS are difficult to quantify because of the variety of nomenclatures given to this condition (“pulmonary edema after pneumonectomy with no identifiable cause”; “edema formation following [jtd.amegroups.com]
Etiology
Etiology It can be due to direct injury to the lymphatic ducts or due to obstruction of the ducts and fragile collateral formations which are prone to spontaneous rupture. [radiopaedia.org]
Etiology of chylothorax in 203 patients. Mayo Clin Proc 2005; 80: 867–70. 2. Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax. J Pediatr 2000; 136: 653–8. 3. [jpss.eu]
[…] duct Pericardial Effusion Definition Increased fluid production Abnormal fluid production Transudative Obstruction of fluid drainage Blockage / occlusion lymphatic channels Exudative Inflammation Infection Neoplasia Autoimmune Pericardial Effusion - Etiology [radiology.vcu.edu]
Etiology Chyle fistulas are rare events. [emedicine.medscape.com]
Epidemiology
Epidemiology Frequency Chylous fistula is an infrequent complication of head and neck surgery, with an incidence reported in 1-3% of patients undergoing major neck surgery. [4] This condition has a predilection for the left side of the neck, but up to [emedicine.medscape.com]
Pathophysiology
Pathophysiology Leakage of lymph from damaged lymph vessels is common after surgery or trauma. [1] However, damaged lymphatics most often heal spontaneously or direct lymph centrally via rich interconnected lymphatic collaterals, without any significant [emedicine.medscape.com]
Introduction Anatomy Pathophysiology Complications Etiology Investigation Management › Medical › Surgical 2. Alkaline,milky, odourless fluid 2-4L produced everyday 3. Chylous fistulas are known to lead to prolonged hospitalization [slideshare.net]
[…] cyst from the median Can be dislocated due to inflammation / fibrosis or previous surgery ( Int J Pediatr Otorhinolaryngol 2003;67:1285 ) Diagrams / tables Images hosted on other servers: Thyroglossal tract Thyroglossal duct cyst Management algorithm Pathophysiology [pathologyoutlines.com]
Prevention
The human and economic costs of the ESRD program serve to emphasize the need to prevent or to arrest those diseases resulting in chronic renal failure, since none of the available treatments is without complications and/or side effects. [books.google.com]
Crumley RL, Smith JD: Postoperative chylous fistula prevention and management. Laryngoscope 1976;86:804–813. Nussenbaum B, Liu JH, Sinard RJ: Systematic management of chyle fistula: The Southwestern experience and review of the literature. [karger.com]
[…] triglyceride supplements and somatostatin analogs. 4 Nonetheless, there are cases in which the high discharge volume ( 1000 ml/day) or the persistence of the fistula for more than 5–7 days indicate the need for more aggressive treatment in order to prevent [elsevier.es]
Primary prevention of these complications can be achieved through adequate surgical planning to minimize lesions, including structured and thorough patient assessment, and centralization of resources and teams. [ncbi.nlm.nih.gov]
The best treatment for chylous leak is to prevent its occurrence. [emedicine.medscape.com]