Bilateral Chylothorax after Neck Dissection

Busquets, José M.; Rullan, Pedro J.; Trinidad‐Pinedo, Juan

doi:10.1016/j.otohns.2003.11.013

Cited by 13 publications

(6 citation statements)

References 10 publications

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“…14 Lobectomy, 15 coronary-artery bypass graft surgery, 16,17 and radical neck dissection have all been associated with the development of a chylothorax. [18][19][20][21] Subclavian vein catheterization with a central line has been associated with in situ thrombosis, resulting in obstruction of the thoracic duct. 22 Nonsurgically related traumatic causes include penetrating injuries from gunshot and knife wounds, fracture-dislocation and hypertension of the spine, and childbirth.…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Chylothorax and Cholesterol Pleural Effusion

Huggins¹

2010

Semin Respir Crit Care Med

110

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A chylothorax and a cholesterol pleural effusion represent the two forms of lipid effusions encountered. Traditionally, a lipid pleural effusion is characterized by the presence of milky fluid. Although these two effusions often share a similar pleural fluid appearance due to the high lipid concentration, they have major differences in the pathogenesis, clinical presentation, diagnosis, predisposing conditions, and management of these effusions. A chylothorax is defined by the presence of chyle in the pleural space resulting from obstruction or disruption of the thoracic duct or one of its major tributaries. A triglyceride concentration > 110 mg/dL is virtually diagnostic, but the presence of chylomicrons confirms the diagnosis. However, a chylothorax defined by these criteria represents a heterogeneous group of clinical entities. The presence of chylomicrons or triglyceride levels > 110 mg/dL in a pleural effusion should be considered evidence of chyle leakage of indeterminate clinical significance. Many cases of a chylous effusion may be associated with other causes of pleural fluid formation. In the case of an acute or chronic chylothorax due to recent or remote thoracic duct injury, this assessment is essential, as surgical ligation of the thoracic duct is often entertained. In other cases, especially lymphoma or chylous ascites, treatment of the underlying condition is indicated regardless, and the assessment of the response to treatment is a reasonable initial approach. In contrast, a cholesterol effusion is typically the result of long-standing pleurisy with elevated cholesterol levels in the pleural space; however, this paradigm has been challenged. Lung entrapment with thickened parietal and visceral pleural membranes is the typical radiographic findings of a cholesterol effusion. Most cases of cholesterol pleural effusions are attributed to tuberculous or rheumatoid pleurisy. Decortication is the mainstay of treatment for a cholesterol effusion in symptomatic patients with restrictive lung function.

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Section: Etiology and Pathogenesismentioning

confidence: 99%

Chylothorax and Cholesterol Pleural Effusion

Huggins¹

2010

Semin Respir Crit Care Med

110

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“…We found only two cases of surgical management reported in the literature, both of which were ineffective [18,19]. The most accepted indications for surgical management are a chyle leak draining more than 1.5 l/day, a leak of chyle at a rate of more than 1 l/day persisting for more than 5 days, or a persistent chyle flow for more than 2 weeks [15,40,41].…”

Section: Discussionmentioning

confidence: 99%

Chylothorax after neck dissection for thyroid carcinomas: report of three cases

Tian

Wang

et al. 2011

Surg Today

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Chylothorax is a rare complication of neck dissection. We report three cases of chylothorax after neck dissections for thyroid carcinoma and attribute this relatively high incidence to the assumption that most patients are asymptomatic. Thus, conventional chest X-ray or ultrasonography in the early postoperative period may be warranted to exclude asymptomatic chylothorax, especially if the thoracic duct is injured and ligated during the operation. We suggest that for chylothorax induced by ligation of the thoracic duct, which may be transient and resolve quickly, short-term thoracic drainage is enough.

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“…Thus, high-output chylothorax requires surgical intervention[31]. However, from the literature we reviewed, only 2 cases were treated with surgery[22],[23], whereas the remaining 24 cases were treated conservatively and recovered at length.…”

Section: Discussionmentioning

confidence: 99%

Bilateral chylothorax following left supraclavicular lymph node dissection for breast cancer: one case report and literature review

Yang¹,

Ren²,

Wang³

2014

Chin J Cancer

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Chylothorax is a rare complication of neck dissection, and bilateral chylothorax is even rarer. However, both are potentially serious and sometimes life-threatening, especially those that are associated with left neck dissection for head and neck neoplasms. We report one case of bilateral chylothorax following left supraclavicular dissection for breast cancer. This case was treated successfully with a new conservative management approach.

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Bilateral Chylothorax after Neck Dissection

Cited by 13 publications

References 10 publications

Chylothorax and Cholesterol Pleural Effusion

Chylothorax and Cholesterol Pleural Effusion

Chylothorax after neck dissection for thyroid carcinomas: report of three cases

Bilateral chylothorax following left supraclavicular lymph node dissection for breast cancer: one case report and literature review

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