Endolymphatic exclusion for the treatment of pediatric chylous ascites secondary to neuroblastoma resection: report of two cases

Chylous ascites is a rare, but highly morbid complication of oncologic resection, often associated with retroperitoneal lymphadenectomy. Conservative measures with total parenteral nutrition or lipid-reduced formulas constitute the initial mainstay therapy, but not without risks and failures. This r...

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Bibliographic Details
Published in:Radiology case reports 2020-07, Vol.15 (7), p.1044-1049
Main Authors: Woerner, Andrew, Shin, David S., Chick, Jeffrey Forris Beecham, Smith, Caitlin A., Sarthy, Jay F., Monroe, Eric J.
Format: Article
Language:English
Subjects:
Chylous ascites
Cone beam computed tomography
Interventional Radiology
Lymphatic
Oncology
Pediatrics
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Summary:Chylous ascites is a rare, but highly morbid complication of oncologic resection, often associated with retroperitoneal lymphadenectomy. Conservative measures with total parenteral nutrition or lipid-reduced formulas constitute the initial mainstay therapy, but not without risks and failures. This report describes 2 endolymphatic treatment strategies for iatrogenic chylous ascites following neuroblastoma resection. Lymphatic leaks were identified using intranodal lymphangiography, targeted with cone-beam computed tomographic guidance, and embolized with n-butyl cyanoacrylate. There were no adverse outcomes, with complete resolution of chylous ascites and a mean follow-up of 26 months.
ISSN:1930-0433
1930-0433
DOI:10.1016/j.radcr.2020.04.060