Percutaneous embolization of thoracic duct injury post-esophagectomy should be considered initial treatment for chylothorax before proceeding with open re-exploration.

Background: Post-esophagectomy patients who develop high-output chylous fistula and chylothorax can be successfully treated with percutaneous ablation thereby avoiding reoperation.

Methods: Five patients with refractory chylous fistula post-esophagectomy were treated with percutaneous embolization. Fistula outputs, evaluation of lymphatic access sites, agents used and additional procedures were analyzed.

Surgical repair of pulmonary artery sling in an adult.

Pulmonary artery sling is a rare congenital vascular anomaly that typically presents in the first month of life with severe respiratory symptoms. In this condition, the left pulmonary artery originates off the right pulmonary artery and courses between the trachea and esophagus, causing compression of both structures. Of those patients with pulmonary artery sling, a small subset survives to adulthood with few or no symptoms.

The effect of abdominal binders on postoperative pulmonary function.

Abdominal binders are ordered by some surgeons postoperatively for patient comfort and to prevent wound complications. There has been some question as to the compressive effect that an abdominal binder has on pulmonary function. We prospectively randomized 54 patients undergoing a midline laparotomy incision to two groups: a "binder" group and a "no binder" group.

Laparoscopic management of the wandering spleen.

Wandering spleen is a rare clinical condition associated with a high incidence of splenic torsion and infarction. The preferred treatment for this condition is splenopexy to reposition the spleen in the left upper quadrant of the abdomen and to preserve splenic function. We present two cases of wandering spleen managed by laparoscopic splenopexy.