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Hepatic oil embolism following lymphography^*

H. Ngan, M.B., M.R.C.P., F.R.C.R.

Queen Mary's Hospital, Roehampton, London, S.W.15

K. W. James, M.A., M.B., F.R.C.R.

Velindre Hospital, Whitchurch, Cardiff

Lymphograms of 1,000 patients were reviewed with special reference to the occurrence of hepatic oil embolism following the procedure. Oily contrast medium ("Lipiodol" ultra-fluid) was found in the liver in seven cases, five of whom had carcinoma of the cervix uteri. Hepatic oil embolism was not encountered in patients with lymphomas in this series. Complete or partial lymphatic obstruction was present in all seven cases and one patient had almost complete obstruction of the inferior vena cava. Malignant disease need not always be the predisposing factor since hepatic oil embolism occurred in one patient with retroperitoneal fibrosis. The routes through which the contrast medium may reach the liver are discussed and lymphaticoportal communications in the mesentery are thought to play an important role. Contrast was invariably seen in the liver within two hours of commencement of the injection and was still faintly visible in one case three and a half months later. The way in which the contrast-pattern in the liver changes with time is described. An attempt is made to correlate the radiological appearances with the fate of the contrast medium in the liver.

^* Paper read at Congressus Tertius, Societatis Radiologicae Europaeae, Edinburgh, June 1975 by Dr. D. K. L. Davies of Velindre Hospital.

Now at Queen Mary Hospital, Hong Kong.

Received for publication August 1, 1976. Revision received April 1, 1978.