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At least 433 records · Page 24Linked to original sources
PubMed1990

[Thoracic duct cyst--a case report].

A case of thoracic duct cyst was reported. The patient, 72 year old man, was admitted with chief complaint of dysphagia. Chest X-ray film demonstrated an ovoid mass at the right upper mediastinum and the esophagus pressed by the tumor to the right. CT scan showed a round tumor with obscure margin located at the right upper mediastinum. Other laboratory data were almost within normal limits. Thoracotomy was performed on March 26, 1987 under diagnosis of leiomyoma of the esophagus. A fluid containing cyst covered with pleura was found at the upper mediastinum. The tumor was connected to the thoracic duct at its upper and lower portion. The cyst was isolated by sharp and blunt dissection without difficulties and removed. The cyst measured 7.5 X 4.5 X 4.5 cm and contained chyle. Pathological examination revealed no evidence of malignancy. Postoperative course of this patient was uneventful, and dysphagia was disappeared.

Aged↗
PubMed1990

[Traumatic chylothorax and chyloperitoneum].

Traumatic chylothorax and chyloperitoneum are rare. Effusion of the chyle into the pleural cavity occurs after severe injuries of the chest wall after pretentious surgical operation in the posterior mediastinum and after operations of the cardiovascular system. The authors recorded one observation after operation of a patent ductus arteriosus and controlled the situation by a conservative procedure. A traumatic chyloperitoneum develops typically after a minor or obscure injury. The pathological picture usually develops slowly, in rare instances it imitates an acute abdomen. The condition calls for laparotomy. Only in rare instances a fissure is detected in the posterior peritoneum and it is very difficult to detect the sites of injuries of lymphatic vessels. The authors treated three patients. All were operated, two were subjected to laparotomy twice. A relapsing chyloperitoneum was brought under control by hitherto non published surgical procedures: in one instance by communication of the abdomen with the posterior mediastinum, in the second case by ligature of the lymphatic vessels close to the vasa mesenterica cran. All patients recovered.

Abdominal Injuries↗
PubMed1989

[Complication related to operative procedure in lung cancer and mediastinal malignancy--report of 6 cases].

Of the patients who underwent surgical treatment for the respiratory system at our hospital over the past 9 years, 6 were postoperatively complicated with chylothorax, 1 with liquorrhea and the other one with paraplegia. Chylothorax occurred after mediastinal lymph node dissection which was carried out for the treatment of malignant tumors. In five cases, it occurred on the left side, and in the sixth case, it occurred on the right side. In 2 patients who received conservative treatment, there was no reduction in chyle outflow, and they died of cerebral infarction and sepsis. The other 4 cases were surgically treated. In 3 of them, the impaired site of the thoracic duct was confirmed by administration of Sudan III before surgery. We confirmed that early reoperation for the chylothorax after lung resection should be performed. Liquorrhea occurred from the 5th costvertebral joint which had been directly infiltrated by lung carcinoma. Fortunately, the postoperative course was uneventful, though the patient complained of dizziness and headache until 14 postoperative days. The case of paraplegia was caused by oxydized cellulose cotton that entered the epidural space via the intervertebral foramen. It was used for hemostasis in the 5th costvertebral joint. This case indicates that oxydized cellulose cotton, which swells when it absorbs water, should be carefully used for hemostasis around the nerves.

Adolescent↗
PubMed1989

CT of intra-abdominal fluid collections.

A wide variety of fluids including ascites, blood, pus, urine, bile, lymph, chyle, mucin, and cerebrospinal fluid can accumulate within the peritoneal and pelvic cavities. The location, appearance, and distribution of this fluid is governed by a number of anatomic and gravitational factors that when carefully analyzed, can help to reveal their source and etiology. Computed tomography is ideally suited to document the presence of abdominal and pelvic fluid collections; display their location and full extent; characterize the fluid and often suggest its source; and provide guidance for percutaneous diagnostic and therapeutic procedures when required.

Body Fluids↗
PubMed1989

[Idiopathic chylothorax in an adult--a case report and a review of 14 cases in Japan].

A 30-year-old female with an idiopathic chylothorax who underwent successful surgical treatment was reported. The patient was referred to our hospital because of massive right pleural effusion found by chance on the X-ray. Thoracocentesis revealed chyle but the etiology was not known by examinations. Conservative treatments such as fasting, intravenous hyper-alimentation and a continuous drainage were performed for 10 weeks without remarkable improvement. A right thoracotomy revealed nothing abnormal except for the oozing of lymph from mediastinal pleura, which was sutured by 3-0 nylon. Postoperative course was uneventful and no recurrent pleural effusion has been recognized for 3 years since then. Adult chylothorax with unknown etiology like this is rare and only 13 cases have been reported in Japan. Such "idiopathic chylothorax" cases, including our case, were reviewed and discussed.

Adult↗
PubMed1989

[A case report of thoracic duct cyst].

A case of mediastinal thoracic duct is described. A 27-year-old female patient was referred to our hospital for abnormal finding of her chest X-ray film, which revealed a mediastinal mass. CT scan, endoscopic ultrasonography, MRI showed that the mass was cystic in the posterior mediastinum. Intra operative ultrasonography demonstrated a thin-walled ovoid cyst containing some high echoic parts inside, which suggested condensed milky fluid. The small pedicle entered the upper pole of cyst was found at surgery and the cyst contained chyle about 300 ml. Histopathological specimen of resected cyst showed a structure of thoracic duct with some lymphoid tissue. Postoperative course was smooth. The characteristic finding of ultrasonography seemed to be valuable in the diagnosis of thoracic duct cyst.

Adult↗
PubMed1989

[Thoracic duct collaterals of lymphatic and pulmonary origin. Anatomy and chylothorax after pulmonary surgery].

Dye injection of lung segments reveals the existence of lymphatic drainage of the lungs generally into cervical venous confluents and more rarely into the arch of the thoracic duct in the neck and also occasionally into the thoracic duct in the mediastinum. Direct drainage of the lymph into the thoracic duct was observed in 10 cases out of a series of 589 injections of lung segments in adult cadavers. In one half of cases, the thoracic duct was injected from the left suprabronchial lymph node chain, the origin of the left recurrent chain, and in one quarter of cases from the lateral anteroposterior right major azygos and left azygo-aortic lymph node chains, not recognised by the classical authors. More rarely, direct lymphatic collaterals drained certain segments of the lower lobes into the thoracic duct via the triangular ligament. Analysis of cases of chylothorax occurring after lung resection and observed in the authors' department or in the literature reveals that most of them can be attributed to a chyle leak from one of these pulmonary lymph collaterals. These pathways are probably also involved in the development of medical or idiopathic chylothorax.

Adult↗
PubMed1989

[The anlage of the duodenal lymphatic bed: morphogenetic prerequisites, structure and importance].

The anlage of the duodenal lymphatic bed takes place on the 3d month of the human intrauterine life. In the intestinal villi there are chyle sinuses, that fuse into presumptive lymphatic vessels, having capillary structure, when they get out of the villi. Intraorganic vessels turn into extraorganic ones, they flow into the pancreatoduodenal lymphatic vessels. In their lumens stromal anlage of the lymphatic nodes are formed as a result of invagination of the blood vessels. Development of the lymphatic bed in the duodenum preceded with formation of intestinal villi (this contributes to absorption of the intestinal content) and deformity of the superior mesenteric vein (this probably makes difficult the organ's drainage). The situation is solved owing to the lymphatic bed anlage. It is, evidently, formed by means of switching off a part of embryonal veins from the blood stream.

Duodenum↗
PubMed1989

[Idiopathic unilateral chylothorax].

A 40-year-old female patient developed spontaneous right-sided chylothorax which after a single thoracocentesis did not relapse. Available examination methods did not reveal the cause of the disease. From the clinical course it may be assumed that the chyle drainage was impaired in the thoracic duct or in a minor lymphatic vessel by subclinical injury, whereby the damage obviously was small, capable of spontaneous closure and healing. The authors present some contemporary views on the pathogenesis, diagnosis and treatment of this rare disease.

Adult↗
PubMed1989

[Mesenteric cysts in Denmark in 1980-86].

On the basis of a material of mesenteric cysts from a period of six years in all Denmark, the symptomatology, diagnosis and treatment of mesenteric cysts (MC) are described. These cysts are rare: approximately one par 130,000 somatic admissions. Mesenteric cysts may be encountered along the entire gastro-intestinal canal from the duodenum to the rectum but are, however, most frequent in the mesentery of the small intestine. The symptoms were variable and depended upon the site, mobility, tension on the mesentery, the complications and, to a lesser extent, on the size. Ultrasonic scanning was the most important diagnostic aid. 5% of the cysts contained chyle and up to one third of these are stated to be malignant. Computed tomographic scanning is recommended preoperative as the density can reveal whether the content is chylous. Enucleation of mesenteric cysts would be attempted but, in cases of large cysts which prove difficult to resect, internal marsupialization may be employed. Material with low frequencies of recurrence and few complications have been presented employing this therapeutic method.

Adolescent↗
PubMed1988

Chylothorax and chylous ascites in a patient with uterine cancer.

A 63-year-old woman, who had undergone radical hysterectomy and radiation therapy for cervical cancer of the uterus three years previously, was found to have pleural effusion and ascites. A diagnosis of chylothorax and chylous ascites was made on the basis of these fluids' characteristics. She received medium-chain triglyceride (MCT) in her diet and intra-venous hyperalimentation to decrease the leakages of chyle into the pleural and peritoneal cavities, but she died of respiratory and renal failures after six months. At autopsy, metastases from the cervical cancer of the uterus to the lymph nodes in the mediastinum and around the abdominal aorta were proved histologically. Lymph node swelling due to metastasis had caused a rupture of the thoracic duct, leading to chylothorax and chylous ascites. The diagnosis, evaluation and therapeutic modalities of the condition are outlined and the literature reviewed.

Carcinoma, Squamous Cell↗
PubMed1988

[Chyledema].

The principal types of reflux of chyle are reviewed in relation to the different pathological localizations at which it may occur, these including chylothorax, chylopericardium, chyloperitonitis, chylous ascites, exudative enteropathies, chyluria, genital chyledema and chylometrorrhea and chylocele, etc. A new approach to therapy of these conditions has been provided by microsurgical techniques which constitute presently an effective procedure for many cases.

Chylothorax↗
PubMed1987

Pulmonary lymphangiomyomatosis complicating pregnancy. A case report.

A 32-year-old primigravida presented with cough and dyspnea at 16 weeks' gestation. Chest roentgenogram revealed a large pleural effusion and diffuse interstitial infiltrates. Moderate arterial hypoxemia and a significant reduction in vital capacity were present. Thoracentesis revealed sterile chyle with no evidence of malignancy. Spontaneous delivery of a healthy infant occurred at 38 weeks, but no change was seen in either the pulmonary infiltrates or chylothorax. Open lung biopsy confirmed the clinical impression of pulmonary lymphangiomyomatosis, and a pleurodesis was performed. Progesterone and estrogen receptor assays on the lung biopsy material revealed only minimal binding. Following two years of therapy with tamoxifen citrate and megestrol acetate, the chylothorax has not recurred, and there has been no other appreciable change in pulmonary function.

Adult↗
PubMed1985

[Initial clinical experiences with the fibrin adhesive Beriplast in heart surgery].

Fibrin glue Beriplast was used during cardiovascular surgery in 97 patients. The fibrin seal was used for hemostasis on anastomoses, patches and suture lines. Moreover, the glue was applied for epicardial fixation of aorto-coronary vein grafts to prevent postoperative graft kinking. Following extrapleural ligation of patent duct in premature infants, the parietal pleura was fastened to the thoracic wall to prevent extrapleural pneumothorax or hemorrhage. After accidental dissection of the thoracic duct in infants, leakage of chyle could be sealed successfully in 6 cases. Hemorrhage from the sealed surfaces of suture lines was not observed. Viral hepatitis occurred postoperatively in 2 patients (3% of the operations for acquired heart disease), both of whom had also received clotting factor concentrate and blood transfusion because of postoperative hemorrhage not related to fibrin sealed surfaces. A causal relation between the hepatitis and application of the pasteurized fibrin glue seems very unlikely. Although fibrin glue certainly cannot replace the surgical suture, it appears to be a valuable aid under special conditions.

Adult↗
PubMed1978

Chylothorax and chylopericardial tamponade following Blalock-Taussig anastomosis.

A case of chylothorax following a right-sided Blalock-Taussig shunt is presented. Chylopericardial tamponade eventually developed, because the mediastinal leakage of chyle was sealed off from the pleural cavity and diverted into the pericardium. Chylopericardium is a rare cause of an enlarged cardiac silhouette on a postoperative chest roentgenogram, but the importance of differentiating it from congestive heart failure is illustrated. When chylopericardial tamponade occurs, treatment consists of (1) aspiration for immediate relief and, if there is recurrence, (2) surgical evacuation of the pericardium with tube drainage or pericardiectomy and (3) ligation of the source of chylous drainage.

Cardiac Tamponade↗
PubMed1982

[Clinical syndromes after subtotal resection of the small intestine (author's transl)].

After subtotal resection of the small gut intestinal function for a certain period of time is not sufficient to guarantee survival of the patient. Prognosis depends upon the length of the residual small gut but also upon its location and upon the ability of the intestine to adapt to the new situation. The use of elemental diets is most important in therapy. Resorption may be improved by applying surgical procedures, which will increase the time of passage of the chyle. If the remaining small intestine is less than 60 cm long in grown ups, or less than 40 cm long in children additional parenteral nutrition is usually necessary. Such nutrition can be given on a home care basis and will enable the patient to survive and lead a normal family and professional life.

Amino Acids↗
PubMed1982

[The origin and transport of chylomicrons in enterocytes in chickens].

After peroral administration of sunflower oil to chick old 14 to 23 days, the rise and passage of chylomicrons were studied electronoptically in the enterocytes of the small intestine. Enterocytes resynthetize the absorbed monoglycerides and fatty acids into neutral fat in the profiles of smooth endoplasmic reticulum and in multivesicular corpuscles in the form of chylomicrons and loose cytoplasmic fat drops in their apical part. The finishing and transport of chylomicrons in the enterocyte are the result of the activity of granular endoplasmic reticulum and the Golgi apparatus. Exocytose carries chylomicrons from enterocytes to intercellular space of the epithelium from where they pass the basal membrane of the epithelium and then, carried by pinocytose, they pass into the lumen of the blood and chyle capillaries. No morphological manifestations of fat absorption in the other cell types of intestinal epithelium (goblet cells, argyrophil cells and intraepithelial lymphocytes) were demonstrated.

Animals↗
PubMed1980

[Lymphoedema and elephantiasis due to filariasis. Pathogenesis and clinical aspects (author's transl)].

Adult lymphatic filariae (Wuchereria bancrofti, Brugia malayi) can cause blocking of lymphatics producing obliterating endolymphitis lesions. The subsequent extravasation of lymph (or chyle when the obstruction is canal) is at the origin of the formation of lymphedema or elephantiasis, in which the main histological finding is great hypertrophy of collagen elements. This theory involving filaria only is not the full picture, and bacterial infection, mainly by streptococci, is an important factor. The association of filaria with microbes is particularly dangerous because the presence of the latter, or its toxins, causes death of local microfilariae and even adult worms, which are known to be more harmful dead than alive. The progression of the disease, especially in cases with lymphedema, which mainly affects the limbs and the genital organs, depends on three factors: the species of filaria, the degree of transmission, and the receptivity of the patient to the parasite. Large differences are found according to the region involved, and in the same endemic zone, according to the individuals affected. However, they almost always occur progressively in areas where there have been recurrent attacks of acute lymphangitis.

Bacterial Infections↗