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Case Reports
. 2020 Jan;99(5):e18816.
doi: 10.1097/MD.0000000000018816.

Ultrasound-guided percutaneous injection of Pseudomonas aeruginosa-mannose sensitive hemagglutinin for treatment of chyle fistula following neck dissection: Two case reports

Affiliations
Case Reports

Ultrasound-guided percutaneous injection of Pseudomonas aeruginosa-mannose sensitive hemagglutinin for treatment of chyle fistula following neck dissection: Two case reports (V体育平台登录)

Qiang Chen et al. Medicine (Baltimore). 2020 Jan.

Abstract

Rationale: Chyle fistula is a rare but troublesome complication of neck dissection VSports手机版. Topical application of Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) injection has been reported as a novel, viable, and effective approach in the treatment of chyle fistula following neck dissection. However, there have been no reports regarding the treatment of chyle fistula using ultrasound (US)-guided percutaneous injection of PA-MSHA. .

Patient concerns: We describe 2 patients with thyroid cancer who developed chyle fistula following neck dissection, which remained unresolved despite the use of conservative treatment. V体育安卓版.

Diagnoses: Both the patients were diagnosed with chyle fistula by laboratory testing, which showed that drainage fluid triglyceride concentration was >100 mg/dL V体育ios版. .

Interventions: When conservative treatment failed, a 2 mL undiluted PA-MSHA preparation was percutaneously injected at the effusion site of the left supraclavicular area under US guidance with aseptic technique. Concomitantly, the drainage tube was clamped for at least 30 minutes. VSports最新版本.

Outcomes: Chyle fistula in both patients were successfully resolved with this technique within 2 or 4 days, without notable side effects V体育平台登录. .

Lessons: US-guided percutaneous injection of PA-MSHA is a simple and effective method to treat chyle fistula following neck dissection, which may serve as a useful addition to the medical treatment for cervical chyle fistula VSports注册入口. .

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures (VSports手机版)

Figure 1
Figure 1
P aeruginosa-mannose sensitive hemagglutinin injection and its outer packaging.
Figure 2
Figure 2
(A) Transverse ultrasound view of the left supraclavicular area shows the location of the effusion site. (B) Ultrasound image shows needle placement (arrow) at the effusion site during real-time ultrasound-guided injection of P aeruginosa-mannose sensitive hemagglutinin preparation.
Figure 3
Figure 3
(A) Transverse ultrasound view of the left supraclavicular area shows the location of the effusion site. (B) Ultrasound image confirms needle placement (arrow) at the effusion site during real-time ultrasound-guided injection of P aeruginosa-mannose sensitive hemagglutinin preparation.

References

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    1. Park I, Her N, Choe JH, et al. Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer. Head Neck 2018;40:7–15. - V体育2025版 - PubMed
    1. Wu G, Chang X, Xia Y, et al. Prospective randomized trial of high versus low negative pressure suction in management of chyle fistula after neck dissection for metastatic thyroid carcinoma. Head Neck 2012;34:1711–5. - PubMed
    1. Kupferman ME, Patterson DM, Mandel SJ, et al. Safety of modified radical neck dissection for differentiated thyroid carcinoma. Laryngoscope 2004;114:403–6. - PubMed
    1. Swanson MS, Hudson RL, Bhandari N, et al. Use of octreotide for the management of chyle fistula following neck dissection. JAMA Otolaryngol Head Neck Surg 2015;141:723–7. - PubMed

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