Plastic bronchitis chylous reflux and lymphatic imaging: a continuing story.

摘要: In 1973, during the 4th International Congress on Lymphology in Tucson, thoracic surgeon Herbert Maier, a devout cardcarrying lymphologist, chatted our office about his latest mission – to raise awareness of what he coined “chyloptysis” and neglected role “(cardio)thoracic lymphatic system” variety rare common disorders. As daily reminder body’s vulnerability dysfunction interstitial fluid drainage system, himself had suffered from recurrent craniopharyngioma for more than 20 years plagued by continuous nasal leak cerebrospinal through re-operated chronically infected cribiform plate. visionary yet long buried paper (1) 1966 Presidential Address American Thoracic Society, called attention lymphatics chest as next frontier surgeons. Further, confessed us frustrating encounters with little known usually fatal lung disease without name (now lymphangioleimyomatosis or LAM), which viewed prime example disordered pulmonary proliferation, influenced female hormones, commonly manifesting chylous effusions occasionally expectoration milky intestinal lymph. He cared compassionately alone group these LAM patients improved their outlook operative approaches complications, rerouting lymph circulation, suppressing hormonal influences. At same time, newly formed Society (ISL) its earliest Congresses (2) was also focusing visualization previously inaccessible peripheral central system invasive lipid-soluble contrast lymphography (LAG) (Kinmonth, Viamonte, Ruttimann, Wallace, Kandl) featuring visceral reflux syndromes treatment including dietary [surgeons Belgium (Godart, Gruwez), France (Servelle), Italy (Tossati) Brazil (Degni, Cordeiro) among others]. this issue Lymphology, an era where cardiac surgery has reached new heights rescuing infants born unsurvivable complex congenital anomalies, Maier’s simple timeless observations resonate case report child successfully treated life-threatening “plastic bronchitis” chyloptysis after series cardiovascular operations leading up Fontan procedure hypoplastic left ventricle (3). Indeed, Pediatric Cardiology Pulmonary Divisions at University