Unilateral pedal lymphography in patients with filarial chyluria

Objective To evaluate the usefulness of unilateral pedal lymphography in pa tients with filarial chyluria. Patients and methods Of 114 patients with filarial chyluria, all underwent lymphography (unilateral pedal in 106) and 55 underwent selective ureteric sampling for chyle, Results Unilateral pedal lymphography in the 106 patients detected lymphati corenal fistulae (LRF) in 104 (98%). Lymphatic crossover was seen in all 10 6 patients, from the second sacral segment to the first lumbar segment. The most frequent crossover site was at the L5 level (87%). There was complete correlation between the side of LRF and the side of chyluria as assessed b y selective ureteric sampling. Conclusion Unilateral pedal lymphography can detect LRF via lymphatic cross over even when it is on the opposite side from that injected with contrast agent. The advantages of unilateral lymphography over bilateral procedures are that it is easy to identify crossover channels, and the discomfort for the patient is reduced because there are fewer incisions and it is quicker. Unilateral lymphography is recommended as the initial method when lymphogr aphy is indicated in filarial chyluria.