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Conservative management with low-fat diet was followed by surgical thoracic duct ligation due to persistent high-output chyle drainage. On postoperative day 14, percutaneous thoracic duct embolization using lipiodol and n-BCA achieved immediate and sustained closure. The patient was discharged 48 hours later without recurrence, supporting embolization as a safe, minimally invasive, highly effective option when standard treatments fail.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/minimally-invasive-radiologic-approach-to-chyle-leakage-after-oncologic-cervical-surgery-a-case-report/432903/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/minimally-invasive-radiologic-approach-to-chyle-leakage-after-oncologic-cervical-surgery-a-case-report/432903.png","ImageObject",300,407,{"name":92,"@type":93},"Rainbow Cat","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What complication occurred after oncologic cervical surgery in this case report?","Question",{"text":112,"@type":113},"The patient developed a refractory cervical chylous fistula following neck surgery for metastatic squamous cell carcinoma.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which conservative and surgical treatments were attempted before embolization?",{"text":117,"@type":113},"Conservative therapy included a low-fat diet, and persistent high-output leakage led to surgical thoracic duct ligation.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the fistula definitively managed, and what was the result?",{"text":121,"@type":113},"Percutaneous thoracic duct embolization with lipiodol and n-BCA was performed on postoperative day 14, resulting in immediate and sustained resolution without recurrence after discharge.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},432903,1790763289,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Radiology Ca s e Reports 21 (2026) 1081 – 1085  \nAvailable online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com)  \njournal [homepage:](homepage: www.elsevier.com/locate/radcr)[ www.elsevier.com/locate/radcr](homepage: www.elsevier.com/locate/radcr)  \n| Case Report\u003Cbr>Minimally invasive radiologic approach to chyle leakage after oncologic cervical surgery: A case report ✩,✩✩\u003Cbr>Adriele Silvaa, Natália Abrahãoa,∗, Valmir Junior, MDb, Túlio Fabiano de Oliveira Leite, MD, PhDc\u003Cbr>a PGY-3, Department of Otorhinolaryngology, Uberlandia Medical Center, Uberlandia, Minas Gerais, Brazil b Department of Otorhinolaryngology – Head & Neck Surgery, Uberlandia Medical Center, Uberlandia, Minas Gerais, Brazil\u003Cbr>c Interventional Radiology, University of São Paulo, São Paulo, Brazil |  |\n| --- | --- |\n| a r t i c l e i n f o | a b s t r a c t\u003Cbr>A 63-year-old male smoker developed a refractory cervical chylous fistula following neck surgery for metastatic squamous cell carcinoma. Despite conservative management with a low-fat diet and subsequent surgical thoracic duct ligation, high-output chyle drainage persisted. On postoperative day 14, percutaneous thoracic duct embolization with lipiodol and n-BCA was successfully performed, resulting in immediate and sustained resolution of the leakage. The patient was discharged 48 hours later without recurrence. This case highlights thoracic duct embolization as a safe, minimally invasive, and highly effective therapeutic option for managing persistent cervical chylous fistulas when conventional treatments fail. The novelty of this report lies in demonstrating that timely image-guided embolization can provide definitive resolution even in severe, surgery-resistant cases, underscoring its growing role as a first-line intervention in selected patients.\u003Cbr>© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington.\u003Cbr>This is an open access article under the CC BY-NC-ND license\u003Cbr>([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) |\n| Article history:\u003Cbr>Received 18 July 2025 Revised 6 November 2025 Accepted 9 November 2025 |  |\n| Keywords:\u003Cbr>Chylous fistula\u003Cbr>Thoracic duct embolization Head and neck surgery Oncology\u003Cbr>Minimally invasive radiological approach |  |\n\nIntroduction  \nCervical chylous fistula is an uncommon but potentially serious complication following neck dissection, with reported incidences ranging from 1% to 2.5% of radical or modified radical procedures [1,2] . It results from injury to the thoracic duct or  \nits tributaries, most commonly during surgery for metastatic head and neck malignancies. Persistent chyle leakage can lead to significant metabolic, nutritional, and immunologic disturbances, as well as prolonged hospitalization and delayed adjuvant therapy [3]. Early recognition and appropriate management are therefore essential to prevent morbidity and optimize outcomes.  \n✩ Competing Interests: The authors have declared that no competing interests exist.  \n✩✩ Acknowledgments: None.  \n∗ Corresponding author.  \nE-mail [address:](address: natmelooh@yahoo.com.br)[ natmelooh@yahoo.com.br](address: natmelooh@yahoo.com.br) (N. Abrahão).  \n[https://doi.org/10.1016/j.radcr.2025.11.025](https://doi.org/10.1016/j.radcr.2025.11.025)  \n1930-0433/© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/))  \nConservative therapy, including dietary fat restriction, total parenteral nutrition, and pharmacologic interventions such as octreotide, is typically the first-line approach. However, in cases of high-output or refractory fistulae, surgical thoracic duct ligation has traditionally been the standard next step [4] . Despite this, surgical re-intervention carries considerable risks and var","cbCaisKCr3GdjKAw","https://ap.wps.com/l/cbCaisKCr3GdjKAw","pdf",1423592,"English","# Introduction\n# Case report\n## Diagnosis and initial management\n## Refractory course and definitive treatment\n## Outcome and discharge","[{\"question\":\"What complication occurred after oncologic cervical surgery in this case report?\",\"answer\":\"The patient developed a refractory cervical chylous fistula following neck surgery for metastatic squamous cell carcinoma.\"},{\"question\":\"Which conservative and surgical treatments were attempted before embolization?\",\"answer\":\"Conservative therapy included a low-fat diet, and persistent high-output leakage led to surgical thoracic duct ligation.\"},{\"question\":\"How was the fistula definitively managed, and what was the result?\",\"answer\":\"Percutaneous thoracic duct embolization with lipiodol and n-BCA was performed on postoperative day 14, resulting in immediate and sustained resolution without recurrence after discharge.\"}]","Minimally invasive radiologic approach to chyle leakage after oncologic cervical surgery - A case report | PDF",1790661854,13]