J Endocr Surg.  2024 Mar;24(1):9-13. 10.16956/jes.2024.24.1.9.

Successful Management of Chyle Leakage Using Thoracic Duct Embolization: A Case Report

• Yi JH
• Jeong HJ
• Lee JS
• Yun HJ
• Lee YS
• Chang HS

• KMID: 2562803
• DOI: http://doi.org/10.16956/jes.2024.24.1.9

Abstract

Chyle leakage (CL) is a rare complication of thyroidectomy. Most patients respond to conservative management, whereas some require surgical intervention. In this report, we discuss the case of a 67-year-old male patient diagnosed with papillary thyroid cancer, who underwent bilateral total thyroidectomy with central compartment neck dissection and left lateral neck dissection. Five days after surgery, the patient developed neck swelling. Despite conservative management with daily aspiration, there was no improvement and dyspnea recurred. Thoracic duct embolization (TDE) was performed by lymphangiography. Consequently, the CL improved. There are various treatments, ranging from conservative treatment to surgical treatment, but there is no consensus on the appropriate management of CL. The patient received only conservative treatment for the low-output chyle leak; however, there was no response. TDE has been reported to have a high success rate for treating CL. TDE is an effective nonsurgical intervention for CL after thyroid surgery.

Keyword

Chyle; Thoracic duct; Lymphography; Thyroidectomy; Neck dissection