Management of Chyle Leak after Neck Surgery: an Uncommon Case Report

Abstract

Chyle leak from iatrogenic thoracic duct injury remains an uncommon but fatal complication of head and neck surgery. The thoracic duct is vulnerable to iatrogenic injury because of its variable course and fragile nature. The present case was a 32-year-old Indian male, with a past history of tongue carcinoma treated surgically followed by chemoradiation. Chyle leak developed following radical neck dissection performed for recurrent metastatic cervical lymph nodes. The patient was initially managed conservatively using head end elevation, use of stool softeners, medium chain fatty acid diet and octreotide therapy. However, the chyle leak did not resolve, and finally surgical intervention was performed which resulted in complete resolution of the chyle leak. A chyle leak can result in various postoperative complications including delayed wound healing, electrolyte disturbances, hypovolemia and immunosuppression. Early identification and prompt treatment play an important role in the favourable clinical outcome in the patient.