What is chyle leak?
Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body.
Where does chyle leak occur?
The majority of chyle leaks occur on the left side, where the thoracic duct enters the base of the neck and travels anterolaterally to empty into the left subclavian vein, usually at or within 1 cm of the junction with the IJV (Fig. 119.9A).
Is a chyle leak life threatening?
Conclusion. High output chyle leak is a rare complication of thyroid surgery. However, in a confined space it could pose a significant threat to patients’ lives.
What is the function of chyle?
Function of Chyle It is produced in the lymph nodes and collected in the thoracic duct. The primary function of chyle is to provide nutrients to the body’s tissues.
What is chyle mean?
A milky-white fluid that forms in the small intestine during digestion. It is made of lymph fluid and fats. Special lymph vessels carry chyle from the intestines to the blood.
What causes chyle?
In children, the most common causes of chylous ascites are congenital abnormalities, such as lymphangiectasia, mesenteric cyst, and idiopathic “leaky lymphatics.” Other congenital causes include primary lymphatic hypoplasia associated with Turner syndrome and yellow nail syndrome, and the lymphatic malformations …
Why does chyle leak happen?
How do you fix a chyle leak?
Octreotide therapy has been shown to be successful in high-volume leaks, with reported success in a 2300-mL chyle leak that persisted after 8 days of MCT diet then resolved 6 days after initiation of octreotide therapy with no adverse events.
How do you test for chyle leak?
Lymphoscintigraphy and magnetic resonance (MR) lymphography are noninvasive diagnostic procedures that can identify leakage of chyle by using contrast specific to the modality of imaging. Lymphangiography is a diagnostic procedure that has regained popularity in recent years.
How chyle is formed?
Chyle (from the Greek word χυλός chylos, “juice”) is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty acids (FFAs). It is formed in the small intestine during digestion of fatty foods, and taken up by lymph vessels specifically known as lacteals.
How do you treat chyle leak?
How do you treat a chyle leak?
How is chyle leakage defined and treated?
Chyle leakage was defined as a milky drainage with a triglyceride level greater than 110 mg/dl. Management of chyle leakage In the first period, all patients who had chyle leakage were treated primarily with conservative management. Conservative management included no enteral feeding and total parenteral nutrition or a low‐fat diet.
What is the most common cause of chyle leaks?
Approximately 60% of chyle leaks are due to lymphoma; 25% due to trauma (iatrogenic or penetrating); other causes make up the remaining 15% of cases (2). The incidence of chyle leaks varies depending on the underlying cause.
How do you know if you have a chyle leak?
DIAGNOSIS The diagnosis of a chyle leak is often subjective, and diagnostic criteria may vary. To confirm that a fluid is chylous, the lipid content should be greater than that of plasma and the protein should be more than half of that of plasma (1). A milky appearance of the drainage fluid is often the initial clue.
What happens if a chyle leak does not heal?
A chyle leak can happen in the lymphatic system after surgery, trauma, or from a routine medical procedure. If the leak does not heal, it can cause damage. Chyle leak nutrition therapy Your health care team wants you to start nutrition therapy to remove fat from your diet. This will help heal your chyle leak.