Assuntos
Bronquite/terapia , Embolização Terapêutica , Imageamento por Ressonância Magnética , Ducto Torácico/diagnóstico por imagem , Ultrassonografia , Adolescente , Bronquite/diagnóstico por imagem , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Imagem Multimodal , Valor Preditivo dos Testes , Punções , Resultado do TratamentoAssuntos
Broncoscopia/métodos , Quilotórax/diagnóstico por imagem , Anormalidades Linfáticas/diagnóstico por imagem , Linfografia/métodos , Quilotórax/patologia , Meios de Contraste/administração & dosagem , Fluoroscopia/métodos , Humanos , Anormalidades Linfáticas/patologia , Anormalidades Linfáticas/terapia , Masculino , Pessoa de Meia-Idade , Corantes de Rosanilina/administração & dosagem , Ducto Torácico/diagnóstico por imagem , Resultado do TratamentoRESUMO
BACKGROUND: Cervical thoracic duct cysts are a rare anomaly. OBJECTIVE: To report a case of cervical thoracic duct cyst, and perform a literature review. CLINICAL CASE: A 78-year-old female, with a one-year history of a left-sided asymptomatic supraclavicular cystic mass. Computerized tomography revealed a cystic mass 42mm in diameter. We performed a fine needle aspiration puncture, obtaining a thick, milky, whitish liquid. The patient underwent surgery; finding a left-sided supraclavicular cystic mass, with some lymph vessels heading towards the jugulo subclavian venous junction. We performed a ligation of these lymph vessels and resection of the mass. The histopathologic study confirmed the diagnosis of thoracic duct cyst. CONCLUSION: Diagnosis of cervical thoracic duct cyst should be suspected with a cystic lesion in the left supraclavicular region, which when perforated exudes a very distinctive thick milky, whitish liquid with a high content of lymphocytes and triglycerides. Treatment should be complete removal with ligation of the lymphatic afferent vessels.
Assuntos
Cisto Mediastínico/cirurgia , Ducto Torácico/cirurgia , Idoso , Biópsia por Agulha Fina , Feminino , Humanos , Ligadura , Vasos Linfáticos/cirurgia , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/patologia , Ducto Torácico/diagnóstico por imagem , Ducto Torácico/patologia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND AIMS: Variceal recurrence after endoscopic band ligation (EBL) for secondary prophylaxis is a frequent event. Some studies have reported a correlation between variceal recurrence and variceal rebleeding with the EUS features of paraesophageal vessels. A prospective observational study was conducted to correlate EUS evaluation of paraesophageal varices, azygos vein, and thoracic duct with variceal recurrence after EBL variceal eradication in patients with cirrhosis. METHODS: EUS was performed before and 1 month after EBL variceal eradication. Paraesophageal varices, azygos vein, and thoracic duct maximum diameters were evaluated in predetermined anatomic stations. After EBL variceal eradication, patients were submitted to endoscopic examinations every 3 months for 1 year. We looked for EUS features that could predict variceal recurrence. RESULTS: Thirty patients completed a 1-year endoscopic follow-up. Seventeen patients (57%) presented variceal recurrence. There was no correlation between azygos vein and thoracic duct diameter with variceal recurrence. Larger paraesophageal varices predicted variceal recurrence in both evaluation periods. Paraesophageal varices diameters that best correlated with variceal recurrence were 6.3 mm before EBL (52.9% sensitivity, 92.3% specificity, and .749 area under the receiver operating characteristic curve [AUROC]) and 4 mm after EBL (70.6% sensitivity, 84.6% specificity, and .801 AUROC). CONCLUSIONS: We conclude that paraesophageal varices diameter measured by EUS predicts variceal recurrence within 1 year after EBL variceal eradication. Paraesophageal diameter after variceal eradication is a better recurrence predictor, because it has a lower cut-off parameter, higher sensitivity, and higher AUROC.
Assuntos
Veia Ázigos/diagnóstico por imagem , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Esôfago/irrigação sanguínea , Ducto Torácico/diagnóstico por imagem , Área Sob a Curva , Endossonografia , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/cirurgia , Esofagoscopia , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Ligadura , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Curva ROC , Recidiva , Prevenção SecundáriaRESUMO
Injuries to the thoracic duct are infrequent but may become life-threatening when chylous leakage persists. This report describes 6 patients with such injuries in whom the leakage resolved spontaneously in one, was corrected using microsurgical lymphatic repair or lymphatic-venous anastomosis in two, successfully treated either by ligation of the thoracic duct or insertion of a peritoneovenous shunt in two, and was eventually controlled after bilateral pleurodesis and thoracic duct ligation by insertion of a peritoneo-venous shunt in one. Conventional lymphography is superior to lymphoscintigraphy and is usually required to document disruption of the thoracic duct.
Assuntos
Ducto Torácico/lesões , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ducto Torácico/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
We describe a case of a patient with idiopathic pericardial effusion that during investigation proved to be a chylopericardium. Lymphangiography showed the chylopericardium to be due to partial aplasia of the thoracic duct. A brief review the etiology, clinical feature, diagnostic procedures and therapeutic possibilities of chylopericardium is presented.
Assuntos
Derrame Pericárdico/diagnóstico , Adulto , Humanos , Linfografia , Masculino , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Ducto Torácico/diagnóstico por imagemRESUMO
The first case in the national literature of chylous ascites following traumatic rupture of Pequet's cistern, confirmed through lymphography is reported. The technique employed and concomitant bone changes are discussed.