Experimental Production of Chylothorax by Occlusion of the Superior Vena Cava

Blalock, Alfred; Cunningham, R. S.; Robinson, C. S.

doi:10.1097/00000658-193609000-00005

Cited by 121 publications

(61 citation statements)

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“…However, not all patients who have right-sided venous hypertension develop chylothorax. 15,16 The development of chylothorax in such cases could be explained by the lymphaticovenous channels within the chest wall, which can contribute to lymphatic drainage in patients who have high central venous pressure. 17 The present patient had an acute clinical presentation, likely because of the large amount of chyle drained by the thoracic duct.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2014

Exp Clin Transplant

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Chylothorax is the accumulation of chyle in the pleural cavity as a result of damage to the lymphatic ducts. We treated a young man who was a kidney transplant recipient who had a prior internal jugular vein permanent catheter for hemodialysis, who developed dyspnea and hypoxemia. Chest radiography showed bilateral pleural effusion. Analysis of the white, milky, cloudy, odorless effusion fluid showed cell count > 500/μL; lymphocytes, 60%; total protein, 3.6 mg/dL; urea nitrogen, 45 mg/dL; creatinine, 90 μmol/L; triglycerides, above 2.2 mmol/L (repeatedly high); lactate dehydrogenase, 450 U/L (normal); and cultures, no growth. Magnetic resonance imaging showed thrombosis of the major neck veins, superior vena cava, and azygos vein. Treatment included pleural drains, gut rest, and dietary modification, octreotide, and warfarin. The chylothorax resolved with no relapse. In summary, chylothorax may occur in patients associated with thrombosis of major veins associated with a permanent dialysis catheter.

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Section: Discussionmentioning

confidence: 99%

Untitled

2014

Exp Clin Transplant

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“…(6,7) In an experimental dog model, chylothorax was induced by superior vena cava ligation, although chylothorax was avoided if the thoracic duct was previously ligated. (29) Patients submitted to cavopulmonary anastomosis are at an increased risk of chylothorax, and some present with high output and are unresponsive to clinical treatment. (4,6,7) In the present study, 85.7% of the patients had high venous pressure, and 42.8% were submitted to cavopulmonary anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Videotoracoscopia como uma opção no tratamento cirúrgico do quilotórax após cirurgia cardíaca pediátrica

et al. 2011

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Objective: To evaluate the use of video-assisted thoracoscopy in the surgical treatment of chylothorax developed after the surgical correction of congenital heart disease in children. Methods: We reviewed the medical charts of 3,092 children who underwent surgery for congenital heart disease between February of 2002 and February of 2007 at the Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, in São Paulo, Brazil. Results: Of the 3,092 children, 64 (2.2%) presented with chylothorax as a postoperative complication. In 50 (78.1%) of those patients, the clinical management was successful, whereas it failed in 14 (21.9%), all of whom were then submitted to thoracic duct ligation by video-assisted thoracoscopy. The thoracic duct ligation was successful in 12 patients (86%) but failed in 2. In the postoperative period, additional clinical measures, such as a low-fat diet and parenteral nutrition, were required in order to resolve those 2 cases. There was no surgical morbidity or mortality. Of the 14 patients who underwent thoracic duct ligation, 5 (35%) died due to cardiac or infectious complications. Conclusions: Video-assisted thoracic duct ligation can be safely performed in patients with severe heart disease, and the outcomes are favorable.Keywords: Chylothorax; Heart defects, congenital; Thoracic duct. ResumoObjetivo: Avaliar o uso de videotoracoscopia no tratamento cirúrgico do quilotórax após cirurgia para correção de cardiopatias congênitas em crianças. Métodos: Revisamos os prontuários médicos de 3.092 crianças operadas para a correção de cardiopatias congênitas no Instituto do Coração/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP) entre fevereiro de 2002 e fevereiro de 2007. Resultados: Das 3.092 crianças, 64 (2,2%) apresentaram quilotórax como complicação pós-operatória. Em 50 (78,1%) dessas, o tratamento clínico foi bem-sucedido, enquanto esse falhou em 14 (21,9%), as quais foram submetidas à ligação do ducto torácico por videotoracoscopia. A ligação do ducto torácico obteve sucesso em 12 pacientes (86%) e falhou em 2 casos, os quais foram resolvidos com medidas clínicas adicionais, como dieta pobre em gorduras e nutrição parenteral. Não houve morbidade ou mortalidade relacionada à operação. Dos 14 pacientes, 5 (35%) faleceram em decorrência de complicações cardíacas ou infecciosas. Conclusões: A ligadura videoassistida do ducto torácico pode ser realizada com segurança em pacientes gravemente enfermos e com doença cardíaca grave, com resultados favoráveis.

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“…The anatomy of the more distal lymphatic sys tem of the abdomen is characterized by multiple anasto moses between lymph vessels and venous channels, and between lymph vessels to one another. In the dog, Bla- lock et al [8] have shown that attempts to block abdom inal lymphatics almost always fail because of this collat eral circulation.…”

Section: Discussionmentioning

confidence: 99%

Acute Chylous Peritonitis

Marangu¹,

Gnassi²,

Chung³

et al. 1991

Dig Surg

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During the management of acute abdominal disease, the intraoperative gross findings assume paramount importance in surgical decision making. Frequently and fortunately, histopathologic confirmation of the disease process is not required to dictate the choice of management options and the operative diagnosis is usually unmistakably correct. Experience of the operating surgeon, coupled with the frequent incidence of these acute abdominal conditions, facilitate their diagnostic accuracy. In this communication, the salient clinicopathologic features of acute chylous peritonitis, a rare condition in which the intraoperative findings can be essential in calling attention to the presence of the disease, are summarized

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Experimental Production of Chylothorax by Occlusion of the Superior Vena Cava

Cited by 121 publications

References 0 publications

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Videotoracoscopia como uma opção no tratamento cirúrgico do quilotórax após cirurgia cardíaca pediátrica

Acute Chylous Peritonitis

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