Correct!
5. All of the above
A thoracic CT scan to look for mediastinal masses and a cardiac ultrasound to look for a cause of elevated right-sided pressures are fairly easily performed and may be useful. If these fail to identify a source or a thoracic duct leak is suspected, two imaging techniques have been used in visualizing the lymphatic system in patients with chylothorax: conventional lymphangiography and lymphoscintigraphy (1). Lymphangiography typically employs bilateral pedal injection of contrast medium (lipiodol) while lymphoscintigraphy utilizes labeled colloids to generate morphological and functional imaging data about the lymphatic drainage. The role of these imaging modalities in the evaluation and management of patients with chylothorax remains poorly defined. In addition, these radiologic techniques may not be available at many medical centers.
A lymphangiogram was performed and was interpreted as normal (Figure 3).
Figure 3. Representative images from the lymphangiogram. The images were interpreted as normal.
Which of the following should be done? (Click on the correct answer to proceed to the sixth of seven pages)