Transudative chylothorax in liver cirrhosis; an underappreciated entity

Abstract

Chylothorax is a rare pathology with potentially severe consequences. Transudative chylothorax remain an extremely rare entity. Cirrhosis is often an underappreciated cause. We report a case of transudative chylothorax in 62-year-old woman with cirrhosis due to hepatitis C.

Hepatic Chylothorax: An Uncommon Pleural Effusion

“…3 Liver cirrhosis accounts for only 1% of chylothorax and occur in association with chylous ascites. 4,5 We present an unusual case of transudative chylothorax due to liver cirrhosis without the presence of significant ascites. Understanding the biochemistry and physiology of chylothorax in liver cirrhosis can help in avoiding unnecessary diagnostic procedures and also aide in effective management.…”

Left Chylothorax Without Ascites in a Liver Transplant Patient

“…Furthermore, chylous ascites with migration to the pleura can occur in patients with congestive heart failure and liver cirrhosis. Chylous ascites in cirrhotic patients most likely develops secondary to elevated portal pressures and diffuse degenerative changes in the lymphatic system leading to leakage of chyle into the peritoneal cavity [1,[3][4][5][6]. The mechanism behind chylothorax formation in liver cirrhosis patients is unclear but is speculated to occur due to translocation of chylous ascitic fluid across small fenestrations in the diaphragm and negative intrapleural pressure [3][4][5][6].…”

“…Chylous ascites in cirrhotic patients most likely develops secondary to elevated portal pressures and diffuse degenerative changes in the lymphatic system leading to leakage of chyle into the peritoneal cavity [1,[3][4][5][6]. The mechanism behind chylothorax formation in liver cirrhosis patients is unclear but is speculated to occur due to translocation of chylous ascitic fluid across small fenestrations in the diaphragm and negative intrapleural pressure [3][4][5][6]. We present the case of a rare left-sided chylothorax without ascites in a patient with prior liver transplantation and transjugular intrahepatic portosystemic shunt (TIPS).…”