Lymphatics Program

Help for Kids With Lymphatic Disease

At the Nemours Lymphatic Imaging & Therapeutics Program, we understand how complex lymphatic disorders can be. Many families try for years to find a solution for their children, who often also have other medical issues. Until recently, kids with lymphatic disease went undiagnosed and untreated. Thanks to recent advances, our large team of specialists is now able to offer both answers and cures for families like yours. Our program combines the expertise of doctors known around the world. We work together, across specialties, to give your child the best, most complete care.

Conditions We Treat

Lymphatics are the very small vessels that carry fluid from the tissue back to the body’s circulation. Although they sound small, when they don’t work right they can cause big problems. Our Nemours lymphatics team checks for and treats lymphatic disease such as:

chylothorax (also called "chylous effusions" — when lymphatic fluid flows into the area between the lungs and chest wall)
chylous ascites (when fluid builds up in the belly)
chyluria (when lymphatic fluid enters the urine, or pee, and makes it look milky white)
lymphedema (when lymphatic fluid stays in the tissue)
plastic bronchitis (when lymphatic fluid builds up in, hardens and blocks the airways, causing breathing problems)
protein-losing enteropathy (when the body loses protein in the intestines, causing belly pain and diarrhea)

Services We Offer

The Nemours Lymphatic Imaging & Therapeutics Program offers a wide range of services for kids with lymphatic disorders, their families, and the doctors who referred them to us.

Our Team

Our large lymphatics team is made up of experts from:

Diagnosis

In the past, it was hard for doctors to understand what the problem was. That’s because the lymphatic vessels were too small for the available imaging options. But in recent years, we’ve developed methods of imaging that allow us to not only see the actual lymphatic vessels, but even watch them in action.

If a vessel is leaking or blocked, we can spot this in real time with imaging tests called “lymphangiography.” We inject a dye into the lymphatic system, either through lymph nodes (small clumps of tissue located along the network of lymph vessels) or through the lymph vessels themselves. Then we watch under a live X-ray called “fluoroscopy” to see what’s going on. We can now see even more detail by using both X-ray and magnetic resonance imaging (MRI). An MRI is a large doughnut-shaped scanner that gives detailed images using a magnetic field and sound waves instead of radiation.

Treatment

Once we figure out the problem, we have a number of tools and ways to fix lymphatic disorders. If the lymphatic vessel is leaking, we block off the leak. If the vessel is closed off, we open it. This involves getting into the lymphatic vessels using tiny needles and wires. During these procedures, the interventional radiology team works closely with cardiologists, pulmonologists and gastroenterologists (GI doctors) to help guide the treatment and reduce risks. Interventional radiology (IR) is the use of medical imaging techniques (such as an ultrasound, CAT scan or fluoroscopy) to guide doctors as they diagnose and treat problems. IR techniques are minimally invasive, which means we use tiny incisions (cuts). And that often means shorter recovery times, very small or no scars, and less pain.

Our Process

Here’s how our program works:

You’ll need to fill out and send us this referral/evaluation form, as well as your child’s records and any imaging tests on discs.
Our whole team will go over your child’s case together once we receive the form, records and discs. This allows each of our specialists to give their input.
We’ll create a “treatment map.” That just means we’ll all work together to map out the treatment plan that will be best for your child.
Our doctors will schedule a phone conference with your family and your home doctors. We’ll explain the plan, and answer any questions you or your doctors may have.
We’ll then schedule your visit and send you a welcome packet. It will include information about your child’s treatment plan, plus resources for housing, travel and what to expect when you get here.
We’ll give you an information packet when we send your child home from the hospital after treatment. It will explain the course of treatment your child received and outline any follow-ups you’ll need. We’ll also include discs from the procedures for your child’s home doctors to review.

From start to finish, we’ll work with you to make the whole experience as stress-free as possible for both your child and your family.

Why Choose Us

At the Nemours Lymphatic Imaging & Therapeutics Program we offer complete diagnosis, evaluation and treatment for children with lymphatic disease. If a physician refers your child to us, up to a dozen of our lymphatics team doctors will review your child’s case so we can work together to decide on the next steps. We combine the expertise of our large team of experts with Nemours’ family-centered care. That means we involve you and your child in deciding on a plan of care. And we make sure your family understands what’s happening every step of the way.

Lymphatics Program Highlights

Delaware Valley/Greater Philadelphia

U.S. News & World Report Best Children’s Hospitals: Gastroenterology & GI Surgery 2018-19

Our Nemours Lymphatic Imaging & Therapeutics Program is available at Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.).

ranked one of the best children’s hospitals in the country for pediatric gastroenterology and GI surgery by U.S. News & World Report
the largest pediatric interventional radiology program in the country (with teams in the Delaware Valley and Florida)
top-notch doctors (who participate on numerous local and national committees representing the specialty in the largest national societies)
cutting-edge treatment and technology (the most advanced pediatric interventional radiology services available)
care for patients around the world (international medicine program can arrange care for children outside the United States)
American College of Radiology (ACR) accreditation (the gold standard in medical imaging) for CT, MRI, ultrasound and PET MRI imaging (positron emission tomography with magnetic resonance, or PET/MR) — assures the highest level of image quality and safety
seamless, coordinated care with on-site doctors in more than 30 pediatric specialties
Ronald McDonald House of Delaware , right across from our campus, for an affordable home away from home during long hospital stays