Thoracic Duct Leak - Forum

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Sweden surgeon

Re: Thoracic Duct Leak - Ärzteforum

Post#11 »

Several days after my original posting, the patient's drain apparently clogged (Jackson Pratt 7mm, flat connected to bulb suction) and patient presented to ER with swelling in the neck. My partner gave patient olive oil (approximately 1/2 cup) and took patient to OR. Also, methylene blue intradermal injection on dorsum of foot. She explored neck, finding chylous appearing fluid, but no discrete leak or source. Fearful of suture ligating blindly, she placed a 10 mm flat JP drain and opened right chest for ligation of thoracic duct above diaphragm. Patient tolerated procedure well, enjoyed a meal on post-operative day 1 and 2 before having recurrent chylous drainage. Her current therapeutic plan is TPN for two weeks, NPO, and continued JP drainage (which is currently putting out approximately 200 - 300 cc daily of clear sero-sanguineous fluid, not chylous appearing. As my partner appreciated the comments previously suggested by members of, I would like to once more request your opinion and suggestions.


Re: Thoracic Duct Leak - Ärzteforum

Post#12 »

I wold not touch anymore the patient at least by now . I would ask you , if the patient have oral nutritional intake without problem why TPN ? . That don't can to lead to more drawback and increasing cost witout objetive benefits?

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Lady Surgeon

Re: Thoracic Duct Leak - Ärzteforum

Post#13 »

Does it help to use a no fat diet? I've not personally encountered this problem, so am just seeking information.


Re: Thoracic Duct Leak - Ärzteforum

Post#14 »

I agree, once you have successfully ligated the thoracic duct, you don't need TPN anymore.

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