Management of delayed chyle leak after thyroid cancer surgery

Chyle leak from thoracic duct injury after head-and-neck surgery is a rare but serious complication that occurs in 0.5%–1.3% of thyroidectomies and 2%–8% of neck dissections. The variable anatomy and fragile composition of the thoracic duct render it prone to injury. The majority of chyle leak occurs with surgery of the left neck; however, up to 25% of chyle leak occur with right neck surgery. Early identification and appropriate management of chyle leak are imperative for optimal surgical outcome. In this case report, we explain a case of carcinoma thyroid for which total thyroidectomy with left lateral neck dissection was done. Postoperatively, there is continuous drainage of chyle from wound site which was managed by re-exploration and repair of injured thoracic duct.