Dual imaging lymphangiography guided treatment of infantile chylothorax.

Chylothorax is a potentially fatal postoperative complication of neck, thoracic, and abdominal surgery in children. We report the case of a 3-month-old infant who developed persistent chylothorax with respiratory insufficiency successfully managed using a microsurgical technique and intraoperative embolotherapy. This was achieved using a combination of intermittent digital X rays and live near-infrared fluorescence imaging we have termed "dual imaging lymphangiography" to guide therapy in real time. The chylothorax resolved and the patient returned to normal diet without recurrence. This microsurgical approach with dual imaging lymphangiography provides a useful tool for intraoperative visualization and treatment of complicated chylothoraces.