Esophagectomy-related thoracic duct injury detected by lymphoscintigraphy with 99mTc-diethylenetriamine pentaacetic acid-human serum albumin: report of a case

Yasuo Tsuda, Masaru Morita, Hiroshi Saeki, Koji Ando, Satoshi Ida, Yasue Kimura, Eiji Oki, Takefumi Ohga, Tetsuya Kusumoto, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshihiko Maehara

Research output: Contribution to journalArticle


Chylothorax is an uncommon but potentially life-threatening complication of esophagectomy. A 72-year-old man underwent thoracoscopy-assisted subtotal esophagectomy and reconstruction with a gastric tube, through a retrosternal route, after preoperative chemoradiotherapy. Chylothorax was detected after starting enteral feeding on postoperative day (POD) 7. Despite conservative therapy such as fasting, total parenteral nutrition, and octreotide administration, massive fluid drainage continued. On POD 19, lymphoscintigraphy with 99mTc-diethylenetriamine pentaacetic acid-human serum albumin (HSA-D) was performed and the site of leakage was detected at the level of the fourth thoracic vertebra. On POD 23, the thoracic duct was ligated, following which the volume of chylothorax decreased. Lymphoscintigraphy 12 days after the reoperation showed no leakage from the thoracic duct. We recommend lymphoscintigraphy with 99mTc-HSA-D for locating the chyle leakage site and helping decide about the operative indication.

Original languageEnglish
Pages (from-to)517-521
Number of pages5
JournalSurgery today
Issue number4
Publication statusPublished - Jan 1 2015


All Science Journal Classification (ASJC) codes

  • Surgery

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