Need for chest radiographs during and after lymphography

Abstract

Retrospective review of 100 lymphograms showed that routine chest radiography after injection of the lymphographic contrast medium and follow-up films 24-48 hr later yielded no clinically useful information. It was concluded that routine postlymphography chest radiography is not necessary and should be reserved for patients in whom complications are suspected.

Clinical approach and review of causes of a chylothorax

“…In a retrospective review, Alejandre-Lafont et al found 79% of patients with a chylothorax, chylous ascites, lymphocele, and lymphatic fistula that underwent lymphangiography had the leak detected [80]. They also found that lymphaniograms were associated with occlusion of the leak in 70% of patients with output of < 500 mL/day and 35% of patients with > 500 mL/day; overall a 51% success, which did not depend on cause of duct damage or time between injury and intervention [80] Lymphangiography may be complicated by oil embolization, lipoid pneumonia, wound infection, pulmonary edema, and urticaria at the site of cannulation [81][82][83]. However, the incidence of complications are directly related to the amount of injected contrast, which should not exceed a total volume of 14 mL [79,84].…”