Skip to main content
SpringerLink
Log in

Novel Lymphatic Imaging and Percutaneous Treatment of Chyluria

  • Case Report
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Chyluria is characterized by the presence of chyle in the urine and often presents clinically as urinary obstruction. Traditional treatments include dietary modifications, surgery and sclerotherapy. The recently developed intranodal lymphangiography and dynamic contrast-enhanced MR lymphangiography (DCMRL) provide better imaging of the lymphatic system. Interstitial lymphatic embolization is a new interventional technique that allows delivery of n-butyl cyanoacrylate glue into the network of the lymphatic vessels. This report describes the demonstration of lympho-urinary tract communications using DCMRL and intranodal lymphangiography in three patients who presented with chyluria, and successful treatment of chyluria in two patients using interstitial lymphatic embolization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sharma S, Hemal AK. Chyluria—An overview. Int J Nephrol Urol. 2009;1:14–26.

    Google Scholar 

  2. Servelle M, Turiaf J, Rouffliange H, Scherer G, Perrot H, Frentz F, et al. Chyluria in abnormalities of the thoracic duct. Surgery. 1963;54:536–49.

    CAS  PubMed  Google Scholar 

  3. Graziani G, Cucchiari D, Verdesca S, Balzarini L, Montanelli A, Ponticelli C. Chyluria associated with nephrotic-range proteinuria: pathophysiology, clinical picture and therapeutic options. Nephron Clin Pract. 2011;119(3):c248–53. https://doi.org/10.1159/000329154 discussion c254.

    Article  CAS  PubMed  Google Scholar 

  4. Chavhan GB, Amaral JG, Temple M, Itkin M. MR lymphangiography in children: technique and potential applications. RadioGraphics. 2017;37(6):1775–90. https://doi.org/10.1148/rg.2017170014.

    Article  PubMed  Google Scholar 

  5. Nadolski GJ, Itkin M. Feasibility of ultrasound-guided intranodal lymphangiogram for thoracic duct embolization. J Vasc Interv Radiol. 2012;23(5):613–6.

    Article  Google Scholar 

  6. Deso S, Kabutey N-K, Vilvendhan R, Kim D, Guermazi A. Lymphangiography in the diagnosis, localization, and treatment of a lymphaticopelvic fistula causing chyluria: a case report. Vasc Endovasc Surg. 2010;44:710–3.

    Article  Google Scholar 

  7. Dhabalia JV, Pujari NR, Kumar V, Punia MS, Gokhale AD, Nelivigi G. Silver nitrate sclerotherapy for chyluria: evaluation for the optimal instillation regime. Urol Int. 2010;85:56–9.

    Article  CAS  Google Scholar 

  8. Brunkwall J, Simonsen O, Bergqvist D, Jonsson K, Bergentz S. Chyluria treated with renal autotransplantation: a case report. J Urol. 1990;143(4):793–6.

    Article  CAS  Google Scholar 

  9. Chen E, Itkin M. Thoracic duct embolization for chylous leaks. Semin Intervent Radiol. 2011;28(1):63–74.

    Article  CAS  Google Scholar 

  10. Itkin M. Lymphatic intervention techniques: look beyond thoracic duct embolization. J Vasc Interv Radiol. 2016;27(8):1187–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sackler School of Medicine, 35 Klatchkin, Tel Aviv-Yafo, Israel

    Alexey Gurevich

  2. Hospital of the University of Pennsylvania, Interventional Radiology, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA, USA

    Gregory J. Nadolski & Maxim Itkin

Authors
  1. Alexey Gurevich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory J. Nadolski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maxim Itkin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexey Gurevich.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, informed consent is not required.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MOV 9911

 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gurevich, A., Nadolski, G.J. & Itkin, M. Novel Lymphatic Imaging and Percutaneous Treatment of Chyluria. Cardiovasc Intervent Radiol 41, 1968–1971 (2018). https://doi.org/10.1007/s00270-018-2035-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-018-2035-8

Keywords

Search

Navigation