The medical staff of the Specialized Hospital Center Dr. Rafael Hernández L., of the Social Security Fund (CSS) in Chiriquí, marked a new milestone in medicine in Panama by performing the first intranodal lymphangiography in a 60-year-old patient who had breathing problems.

Previously, the chest X-ray visualized right pleural effusion, and after making the diagnosis of traumatic quilothorax, the patient was operated on, detailed Dr. Sikia Wong, subspecialist in interventional radiology and endovascular therapy at the Hospital Dr. Rafael Hernández L., who explained that the most common is to perform lymphangiography through the approach on the foot, using methylene blue.

“This time, the intervention was done through a ganglion in the groin, to reach the lymphatic system, because the patient presented abnormal accumulation of the liquid located between the thin layers of the tissue (pleura) that covers the lung and the wall of the thoracic cavity,” added Dr. Wong.

After the drainage, the patient was taken to the procedure achieving improvement. This intervention can be performed in patients with pathologies such as chylothorax, ascitis chilosa (fluid inside the abdomen), chiluria (lymphatic fluid that leaks into the inside of the bladder) or suspected lymphatic vessel injury secondary to trauma or neoplasms.

“In many cases, the diagnostic procedure alone is enough to offer treatment. They are patients with an oncological or traumatic history, among others, that can cause an abnormal accumulation of chylous fluid, and the patient presents a clinical picture that will depend on where it is located,” said Dr. Wong.

For example, in chylous ascites or accumulation of fluid inside the abdomen, which can be of neoplastic origin or surgical injury, an increase in the perimeter of the abdomen is manifested, when performing an imaging study.

The beneficiaries of this procedure are those patients who are subjected to multiple drainages, which involves possibilities of infection, multiple visits to hospitals; which, in some cases, involves large expenses, both for the patient and for the institution.

The Dr. Rafael Hernández L. Specialized Hospital Center has a modern high-quality imaging service and interventional radiology and endovascular therapy, which allows these innovative procedures to be performed for the benefit of the patient, concluded Dr. Wong.