Fig. 4.

A 41-year-old man status-post retroperitoneal lymphadenectomy with persistent chylous ascites. ( a ) Multiple surgical clips overlying the spinal column. Intranodal lymphangiography reveals amorphous leakage of contrast material bilaterally (black arrowheads) at L4 and L5 levels, which is different in shape from lymph nodes (black arrow). No cephalad progression through the retroperitoneal lymphatics was present. ( b ) Spot radiographs of the abdomen taken after no cephalad progression of ethiodized oil was noted. White arrows reveal areas of intrahepatic oil, in a branching pattern. ( c ) Computed tomography of the abdomen after the spot radiographs revealed intrahepatic oil. A portal venous distribution of ethiodized oil is present (black arrow). No change in liver function tests was present and the patient remained asymptomatic.