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Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy

Protein-losing enteropathy (PLE) is a severe complication of the Fontan procedure that leads to systemic complications owing to enteric protein loss. Hepatoduodenal lymphatic leakage resulting from increased lymphatic pressure is one such complication. We present the case of a pediatric heart transp...

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Autores principales: Trocchia, Carolena, Mauer, Tian, Mitchell, Sally, Collard, Michael, Asante-Korang, Alfred, Wilsey, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684213/
https://www.ncbi.nlm.nih.gov/pubmed/38034460
http://dx.doi.org/10.1097/PG9.0000000000000381
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author Trocchia, Carolena
Mauer, Tian
Mitchell, Sally
Collard, Michael
Asante-Korang, Alfred
Wilsey, Michael
author_facet Trocchia, Carolena
Mauer, Tian
Mitchell, Sally
Collard, Michael
Asante-Korang, Alfred
Wilsey, Michael
author_sort Trocchia, Carolena
collection PubMed
description Protein-losing enteropathy (PLE) is a severe complication of the Fontan procedure that leads to systemic complications owing to enteric protein loss. Hepatoduodenal lymphatic leakage resulting from increased lymphatic pressure is one such complication. We present the case of a pediatric heart transplant patient who experienced refractory PLE symptoms requiring serial albumin infusions and exhibited lymphatic leakage into the duodenum. Using diagnostic lymphangiography and endoscopy, we identified the affected area and treated it successfully with endoscopic sclerotherapy using ethanolamine injection. This treatment allowed for the cessation of lymphatic fluid and may serve as a potential intervention for PLE-associated hepatoduodenal lymphatic leakage. The present case highlights the importance of early recognition and timely intervention with radiology and endoscopic therapy to manage PLE and its associated complications.
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spelling pubmed-106842132023-11-30 Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy Trocchia, Carolena Mauer, Tian Mitchell, Sally Collard, Michael Asante-Korang, Alfred Wilsey, Michael JPGN Rep Case Report Protein-losing enteropathy (PLE) is a severe complication of the Fontan procedure that leads to systemic complications owing to enteric protein loss. Hepatoduodenal lymphatic leakage resulting from increased lymphatic pressure is one such complication. We present the case of a pediatric heart transplant patient who experienced refractory PLE symptoms requiring serial albumin infusions and exhibited lymphatic leakage into the duodenum. Using diagnostic lymphangiography and endoscopy, we identified the affected area and treated it successfully with endoscopic sclerotherapy using ethanolamine injection. This treatment allowed for the cessation of lymphatic fluid and may serve as a potential intervention for PLE-associated hepatoduodenal lymphatic leakage. The present case highlights the importance of early recognition and timely intervention with radiology and endoscopic therapy to manage PLE and its associated complications. Lippincott Williams & Wilkins, Inc. 2023-11-13 /pmc/articles/PMC10684213/ /pubmed/38034460 http://dx.doi.org/10.1097/PG9.0000000000000381 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Report
Trocchia, Carolena
Mauer, Tian
Mitchell, Sally
Collard, Michael
Asante-Korang, Alfred
Wilsey, Michael
Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy
title Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy
title_full Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy
title_fullStr Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy
title_full_unstemmed Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy
title_short Lymphatic Leakage in Pediatric Heart Transplantation: Early Recognition and Timely Management with Interventional Radiologic and Endoscopic Therapy
title_sort lymphatic leakage in pediatric heart transplantation: early recognition and timely management with interventional radiologic and endoscopic therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684213/
https://www.ncbi.nlm.nih.gov/pubmed/38034460
http://dx.doi.org/10.1097/PG9.0000000000000381
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