Surgical repair of massive chylous leakage with a supraclavicular artery island flap


Department of Plastic, Reconstructive and Aesthetic Surgery, Centro Hospitalar de São João, Porto, Portugal


Department of Otorhinolaryngology, Centro Hospitalar de São João, Porto, Portugal

B-ENT 2019; 15: 43-46
Read: 661 Downloads: 487 Published: 28 January 2020

Introduction: head and neck oncologic surgery is associated with multiple post-operative complications. Chylous leakage is an infrequent but potentially severe complication that frequently requires surgical management.

Case report: we report a case of a patient who presented an iatrogenic injury of the thoracic duct leading to massive chylous leakage, following major neck surgery. As conservative treatments failed, a left supraclavicular artery island flap (SCAIF) was designed and raised to repair the site. Simultaneously, a contralateral SCAIF was harvested to reconstruct the anterior esophageal wall due to tracheostomal dehiscence. Chyle leakage reduced during the following days and no other major postoperative complications were registered.

Discussion/Conclusion: to our knowledge, this is the first report of the usage of SCAIF in the management of chylous leakage. This fasciocutaneous flap has shown to be safe, easy to dissect and reliable, obviating the need for more complex reconstruction techniques.

EISSN 2684-4907