Chylous fistula.

Chylous fistula, one case of which was associated with chylothorax, appeared in three patients. Attention is directed to the variations in the anatomical distribution of the cervical lymphatics. Evidence of chyle extravasation occurs within hours after neck dissection, and is not difficult to diagnose. Experience and surgical knowledge dictate that prompt exploration of the wound and control of the leaking areas by ligatures or pressure packing or both is indicated, although in certain less severe cases, external pressure and dietary control may be effective. In one case presented here, by the time reexploration was carried out, a chyloma had developed and it was impossible to identify the structures in the neck. An unusual treatment modality, surgical glue, was utilized to plug the fistula.