The Management of Chylothorax

Valentine, Vincent G.; Raffin, Thomas A.

doi:10.1378/chest.102.2.586

Cited by 256 publications

(255 citation statements)

References 24 publications

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“…Although the milky appearance is found in only 50% of the chylothoraces and its absence does not exclude the diagnosis, it was likely not the original etiology of our patient's pleural effusion, especially because it was transudative in nature (3). There were no findings on chest CT scan consistent with lymphoma, or other common non-traumatic etiologies for chylothorax such as other malignancies or lymphangioleiomyomatosis (7,8). We believe a traumatic chest tube insertion had injured or disrupted the lower part of the thoracic duct and the mediastinal pleura, resulting in a chylothorax.…”

Section: Discussionmentioning

confidence: 91%

Chylothorax: A Rare Complication of Tube Thoracostomy

Limsukon

Yick

Kamangar

2011

The Journal of Emergency Medicine

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e Abstract-Background: Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported. Objective: The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy. Case Report: An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet. Conclusion: The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube.

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Section: Discussionmentioning

confidence: 91%

Chylothorax: A Rare Complication of Tube Thoracostomy

Limsukon

Yick

Kamangar

2011

The Journal of Emergency Medicine

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“…1 Trauma, especially as a result of surgery (e.g., esophageal surgery), is the second most common cause of chylothorax. 1 Nonmalignant, nontraumatic conditions such as tuberculosis, amyloidosis, lymphangiomyomatosis, filariasis, obstruction of the superior vena cava, retrosternal goitre, hemangiomatosis, yellow nail syndrome and sarcoidosis can also lead to chylothorax. …”

Section: Discussionmentioning

confidence: 99%

Bilateral pleural effusions

McGrath¹,

Barber²

2010

Canadian Medical Association Journal

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“…[2][3][4] Clinically, dyspnoea, chest pain and cough are the most common symptoms of chylothorax. Malnutrition from loss of protein and immunosuppression from loss of immunoglobulins into pleural space might lead to weight loss and infections.…”

Section: Introductionmentioning

confidence: 99%