ABSTRACT
To bring about a positive clinical outcome in treating lymphatic and chylous disorders, especially when microsurgical solutions are indicated, an accurate diagnostic assessment is of utmost importance. The main indications to the use of direct oil contrast lymphangiography are represented by chylous disorders, such as chyloperitoneum, chylothorax, chylous cysts, mediastinal chyloma or chylomediastinum, chylopericardium, chyluria, chylo-colpometrorrhea, chyloedema of external genitalia and of lower extremities, with chylo-lymphostatic verrucosis and subsequent chylo-lymphorrhea, and chylous joint effusion. Conventional lymphangiography can be performed in two different ways: (1) by injecting Lipiodol Ultra Fluid after isolation and cannulation of the lymphatics of the dorsum of the foot with microsurgical technique; or (2) by intranodal injection of contrast medium. Oil contrast lymphangiography represents the only diagnostic investigation that can supply precise topographic information about the site and cause of the chylous disorders. On the base of lymphangiographic findings, the proper therapeutic management is planned.
