A Very Uncommon Case of Transudative Chylothorax: A Case Report and Literature Review

Abstract

The presence of chyle in the pleural cavity is referred to as chylothorax. Exudative chylothorax is usually related to damage or obstruction of the lymphatic vasculature with subsequent leakage into the pleural space. In contrast, transudative chylothorax is related to increased hydrostatic pressure caused by elevated intra-abdominal pressure, which leads to the translocation of chylous fluid into the pleural space. Cirrhosis is the most common cause of transudative chylothorax, commonly presenting with ascites and portal hypertension. To the best of our knowledge, isolated transudative chylothorax as a consequence of cirrhosis is exceptionally rare and has been scarcely reported in the literature. We herein report a female patient in her fifties who presented to our hospital with isolated unilateral transudative hepatic chylothorax, with no clinical evidence of cirrhosis or any stigmata of portal hypertension at the time of presentation.

A Unique Case of Chylothorax Occurring Post-Chest Tube Insertion

“…If conservative measures fail, pleurodesis has been shown to treat chylothorax when output is low. Some refractory cases can be treated with the transhepatic intrajugular portosystemic shunt (TIPS) procedure [8].…”