Leak from Duplicated Thoracic Duct Treated with Embolization

Injury to the thoracic duct leads to the leakage of chyle into the pleural space causing a chylothorax. The most common cause of chylothorax in children is injury from cardiac surgery when the mediastinum is dissected. It is important to diagnose and localize the chyle leak. Today, intranodal lymphangiography with MRI is the gold standard for diagnostic imaging and guidance of therapy. Medical management is often the initial therapy. If unsuccessful, image-guided embolization is the initial treatment of choice and is an effective treatment for a persistent chylothorax after unsuccessful medical management.