Modified Blood Patch Used to Treat a High Output Chyle Leak after McKeown Esophagectomy

Abstract Chyle leaks after esophagectomy are associated with significant morbidity and mortality. High output fistulas are particularly difficult to manage, as the likelihood of spontaneous closure with conservative management is low. Leaks that fail to resolve with conservative management are referred for thoracic duct ligation or embolization. Some patients, however, are not candidates for these procedures or have persistent output despite intervention. We report a case of a post McKeown esophagectomy patient with a high output chyle leak despite intraoperative thoracic duct ligation, which was successfully treated with a modified blood patch through a neck drain.