A 63-year-old man developed a serious leak of a special body fluid called chyle after surgery to remove cancer from his neck. Even after trying diet changes and another surgery, the leak wouldn’t stop. Doctors used a special imaging technique to guide a tiny tube into the leaking vessel and seal it shut with special materials. This worked immediately, and the patient went home two days later without any more problems. This case shows that this newer, less invasive method might be a better first choice for treating these stubborn leaks compared to traditional surgery.

The Quick Take

  • What they studied: Whether a minimally invasive imaging-guided procedure could successfully treat a persistent fluid leak that developed after neck cancer surgery
  • Who participated: One 63-year-old male patient who was a smoker and had undergone surgery for metastatic squamous cell carcinoma (a type of skin cancer that had spread)
  • Key finding: The image-guided sealing procedure completely stopped the fluid leak immediately, with no return of the problem during follow-up
  • What it means for you: If you or a loved one develops a stubborn fluid leak after neck surgery, this newer technique might offer a faster solution than traditional surgery. However, this is based on one patient’s experience, so talk with your doctor about whether it’s right for your situation

The Research Details

This is a case report, which means doctors documented what happened with one specific patient. The patient had neck surgery to remove cancer, but afterward developed a leak of chyle (a milky fluid that normally travels through the body’s lymph system). The doctors first tried the standard approach: asking the patient to eat a low-fat diet to reduce chyle production. When that didn’t work, they performed traditional surgery to tie off the thoracic duct (the main vessel carrying chyle). Even after this surgery, the leak continued on day 14 after the original operation.

At that point, the doctors tried something different. They used imaging (like an X-ray) to guide a thin tube to the exact location of the leak. Through this tube, they injected special materials designed to seal the leaking vessel shut. This is called embolization, and it’s much less invasive than traditional surgery because it doesn’t require large incisions.

The procedure worked immediately. The leak stopped right away, and the patient was able to go home just two days later without any return of the problem.

This approach matters because chyle leaks after neck surgery can be serious and difficult to treat. Traditional methods don’t always work, and repeated surgeries can be hard on patients. This case suggests that using imaging-guided techniques earlier in treatment might help patients recover faster and avoid multiple surgeries

This is a single case report, which is the lowest level of scientific evidence. It shows that the procedure worked for one patient, but we can’t know if it will work the same way for everyone. The patient had good outcomes, but more research with many more patients would be needed to confirm this is the best approach. The fact that it was published in a medical journal means doctors reviewed it, but a case report is mainly useful for showing that something is possible, not for proving it works for all patients

What the Results Show

The image-guided sealing procedure (called percutaneous thoracic duct embolization) successfully stopped the chyle leak immediately. The patient had no further drainage after the procedure. He was discharged from the hospital just 48 hours after the procedure and had no return of the leak during follow-up.

This is particularly impressive because the leak had persisted despite two previous treatment attempts: first with dietary changes and then with traditional surgery. The fact that this minimally invasive approach worked when more invasive methods had failed suggests it might be a powerful option for difficult cases.

The procedure itself was well-tolerated by the patient with no reported complications from the embolization technique itself.

The patient’s quick recovery and discharge suggest that this minimally invasive approach may allow patients to leave the hospital sooner compared to traditional surgery. The lack of recurrence during follow-up indicates the seal appears to be durable and lasting

Traditionally, persistent chyle leaks have been treated with dietary management first, followed by surgical ligation (tying off) of the thoracic duct if needed. This case suggests that image-guided embolization might be more effective than traditional surgery for certain patients, potentially becoming a first-line treatment rather than a last resort. However, this is based on one patient’s experience, so more research is needed to compare it directly to traditional approaches

This is a single case report with only one patient, so we cannot know if these results would happen for other patients. The patient had specific characteristics (age 63, male, smoker) that might affect outcomes. We don’t know the long-term results beyond the immediate follow-up period. There’s no comparison group to see how this compares to other treatments. The doctors may have selected this patient because they thought the procedure would work well, which could make the results look better than they would be if tried on all patients with this problem

The Bottom Line

If you develop a persistent chyle leak after neck surgery that doesn’t respond to diet changes or initial surgery, ask your doctor about image-guided embolization as a possible option. This case suggests it may be effective, but discuss the risks and benefits specific to your situation. This should be done at a medical center with expertise in this procedure (moderate confidence based on one case)

This information is most relevant to people who have had neck cancer surgery and develop persistent chyle leaks. It’s also important for surgeons and interventional radiologists (doctors who use imaging to guide procedures) who treat these complications. Family members of cancer patients may want to know about this option if complications develop. People without chyle leaks don’t need to worry about this information

Based on this case, the procedure provided immediate relief, with the patient discharged within 48 hours. However, long-term durability beyond the follow-up period shown in this case is unknown

Want to Apply This Research?

  • If you’ve had this procedure, track daily fluid drainage amounts (if any), wound appearance, and any signs of infection or recurrence. Note these measurements at the same time each day
  • Work with your medical team to follow any dietary recommendations post-procedure. Log your meals to ensure compliance with any low-fat diet if recommended, and report any changes in drainage or symptoms immediately
  • Set weekly reminders to check and document the surgical site appearance. Create alerts for any warning signs like increased drainage, fever, or swelling, and report these to your healthcare provider immediately

This case report describes the experience of one patient and should not be considered proof that this treatment will work for everyone. Chyle leaks and their treatment are serious medical conditions that require individualized care from qualified healthcare providers. If you have had neck surgery and develop symptoms of a chyle leak (such as fluid drainage from the surgical site), contact your surgeon immediately. Do not attempt to self-treat or delay seeking medical attention. The information in this article is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult with your healthcare team before making decisions about your medical care.