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

International Journal of Surgery Case Reports
Ninos AnestisPierrakakis Stephanos

Abstract

A thoracic duct injury complicated with a chylous fistula is a rather rare occurrence associated with left subclavicular catheterization. We present a new method of its conservative management which seems to be the least interventional described so far. It can be used in cases of this iatrogenic injury irrespective of the rate of chyle loss. Our case report involves a 59-year-old patient with a high-output chyle fistula due to left subclavicular vein catheterization, in which biological cyanoacrylic glue was used through percutaneous infusion to the venous angle, where the thoracic duct was leaking. An extensive review of the relevant literature is presented. Most of the high-output fistulas require a long time of conservative treatment, which may result in severe complications due to the prolongation of chyle loss. An operation may be needed in selected cases. Our proposed interventional method can be used in cases of percutaneous injury of a chyle duct, with immediate results. An iatrogenic chyle fistula due to left subclavicular catheterization can be obtained with a percutaneous injection of biological glue directly onto the injured vessel.

References

Jul 1, 1989·The Annals of Thoracic Surgery·E AkaogiM Hori
Jun 1, 1986·Archives of Otolaryngology--head & Neck Surgery·R MetsonT C Calcaterra
Jul 1, 1973·The British Journal of Surgery·P Kinnaert
Jul 1, 1981·The Annals of Thoracic Surgery·G A PattersonJ D Cooper
Nov 1, 2000·Surgery·O O AalamiC H Organ
Mar 5, 2002·Journal of Vascular and Interventional Radiology : JVIR·Stephen S KwonHarold A Mitty
Jul 5, 2003·The Annals of Thoracic Surgery·Takehiko MatsuoKazunori Yoshida

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Citations

Feb 17, 2017·International Journal of Otolaryngology·Sean W DelaneyUttam K Sinha
Aug 16, 2016·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Taryn HoffmanMarios Loukas
Jul 10, 2018·Advances in Wound Care·Witold W Kilarski

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