Superior Mediastinum Lymphatic Vessel Injury Diagnosed and Treated by Lymphangiography after Coronary Artery Bypass Grafting
- VernacularTitle:上縦隔リンパ管損傷をリンパ管造影によって診断・治療しえた冠動脈バイパス術後の1例
- Author:
Takashi SHIMADA
1
;
Tsuneo ARIYOSHI
1
Author Information
- Keywords: cardiovascular surgery; Chylothorax; lymphoangiography
- From:Japanese Journal of Cardiovascular Surgery 2024;53(5):263-266
- CountryJapan
- Language:Japanese
- Abstract: A 66-year-old female patient was diagnosed with unstable angina and atrial fibrillation, and underwent coronary artery bypass grafting, pulmonary vein isolation, and left atrial appendage closure. After the surgery, only a small amount of pale blood drainage was observed from the drain, which is a normal occurrence following surgery. However, approximately 15 h after surgery, the drain discharged 300 ml of serous fluid per 4 h. A large amount of fluid continued to be drained, amounting to 500-900 ml per day. It continued to be serous even after resuming oral intake, differing from the typical course of lymphorrhea accompanied by chylothorax. Based on a biochemical test result and characteristics of the drainage fluid, lymphorrhea was suspected; therefore, we started a fat-restricted diet and subcutaneous injections of octreotide, as in the case of chylothorax. However, drainage continued. Finally, lymphangiography using Lipiodol was performed for diagnostic and therapeutic purposes, and the lymphorrhoea improved.
