Treatment Options in Patients With Chylothorax

Abstract

Interventional radiological procedures have now taken their place alongside conservative treatment and surgery in the management of chylothorax, although they are currently available in only a small number of centers.

Infected chylothorax: a case report and review

“…Third, the available data suggest a surprisingly good prognosis considering a previously estimated morality of 10-25% in non-infected chylothoraces, depending on etiology (27). The one patient who did not survive to discharge died due to brain herniation.…”

Chyle fistula in advanced and metastatic thyroid cancer

“…It is difficult to reassure whether this immediate intervention had an impact on the control of the problem but it needed to be done. There is no doubt that a chylothorax requires proper management by the thoracic surgery unit not only to drain the pleural effusion alleviating the patient's respiratory symptoms but also to finally control the fistula if conservative measures or interventions like the ones described including embolization of the duct by interventional radiology fails like in our patient number 3, requiring a definitive treatment to control the problem (1)(2)(3)(4)(5)(11)(12)(13)(14)(15)(16)(17). In regards to a right thoracic duct fistula, we did not have any symptomatic fistulas in this side, and we reinstate "symptomatic" since it is a low activity duct draining less than 20-25% of the body's lymph, limiting itself to the right upper chest, neck and craniofacial and right arm.…”

“…Indeed, one of the main goals of a complex left lower neck dissection for gross metastatic disease is to be always on the look for the lymphatic leakage as the surgeon is resecting the affected lesions, as the principal ways to prevent it from happening. If there is doubt regarding the presence of a CF in the postoperative period, one can always order a lab analysis of such fluid in order to measure the fatty component to confirm the presence of triglycerides in the liquid (1,2,(12)(13)(14).…”

Recurrent Chylothorax Caused by a Retained Guidewire in a Central Vein: A Case Report

“…A chylothorax results from leakage of lymphatic fluid, and is caused by obstruction or injury of the thoracic duct 1) . Nontraumatic chylothorax results from increased superior vena cava pressure due to malignancy, lymphangioleiomyomatosis, sarcoidosis, cirrhosis, tuberculosis, or thrombosis causing venous obstruction 2,3) .…”