Chylothorax as a complication of extensive spontaneous left arm DVT

Gohar, Ahmed; Jamous, Fady; Meyer, Natasha

doi:10.1136/bcr-2019-232563

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…Chylothorax, secondary to venous thrombosis, has been reported in previous studies, and it was frequently described in patients with central vein line. 13,48,49 The obstruction of the vena cava may lead to a partially obstructed outflow of the thoracic duct and lymphatic vessels, increasing the lymphatic pressure and thus leading to rupture or micro perforation and consecutive chylothorax. It is tempting to speculate that the association of vena cava thrombosis and chylothorax in CDH may follow the same pathomechanism and chylothorax may be the result of vena cava thrombosis in CDH.…”

Section: Discussionmentioning

confidence: 99%

Vena Cava Thrombosis after Congenital Diaphragmatic Hernia Repair: Multivariate Analysis of Potential Risk Factors

et al. 2021

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Introduction The treatment of newborns with congenital diaphragmatic hernia (CDH) is associated with a significant complication rate. Information on major thrombotic complications and their incidence in newborns with CDH is lacking. The aims of our analysis were to evaluate the frequency of vena cava thrombosis and to determine its predictors within a consecutive series of patients with CDH. Materials and Methods We retrospectively analyzed charts of all neonates of our department that underwent CDH repair from 2007 to 2021, focusing on vena cava thrombosis. Vena cava thrombosis was diagnosed sonographically and classified as complete or partial venous occlusion. Complete occlusion was confirmed by cavography. Variables evaluated were CDH side, liver position, central vein line, surgical approach, and extracorporeal membrane oxygenation (ECMO). Univariate and multivariate tests were utilized. Results Among 57 neonates who underwent CDH repair, vena cava thrombosis was diagnosed in 14 (24.6%), seven of whom had complete occlusion of the vena cava. Factors associated with vena cava thrombosis were femoral or saphenous venous catheter (p = 0.044), right sided CDH (p = 0.027) and chylothorax (p < 0.0001). ECMO was not associated with vena cava thrombosis. Seven patients (50%) with vena cava thrombosis were treated interventionally with angioplasty and seven (50%) conservatively with anticoagulation only. Mortality was not higher in patients with compared with patients without vena cava thrombosis. Conclusion The incidence of vena cava thrombosis in newborns with CDH in our series is high. Routine postoperative abdominal sonography focusing on vena cava thrombosis is mandatory in all patients with CDH. Patients who developed vena cava thrombosis were more likely to develop chylothorax after CDH repair. Considering the good outcome of medical therapy of partial vena cava thrombosis, it may be discussed whether low dose anticoagulation may be provided to all newborns with CDH.

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Section: Discussionmentioning

confidence: 99%

Vena Cava Thrombosis after Congenital Diaphragmatic Hernia Repair: Multivariate Analysis of Potential Risk Factors

et al. 2021

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“…Causes of chylothorax can be traumatic or nontraumatic. Nontraumatic causes include malignancies, sarcoidosis, and congenital lymphatic duct malformations [ 1 ]. Here we present the case of a patient who came in because of hypotension and was found to have a right-sided hydropneumothorax.…”

Section: Introductionmentioning

confidence: 99%

A Unique Case of Chylothorax Occurring Post-Chest Tube Insertion

Syed¹,

Khurshid²,

Wireko³

et al. 2023

Cureus

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Chylothorax is a relatively rare condition characterized by the accumulation of chyle, a milky lymphatic fluid, within the pleural space. It occurs because of disruption or obstruction of the thoracic duct or its tributaries, leading to chyle leakage into the pleural cavity. We present an interesting case of chylothorax that occurred as a complication post-chest tube insertion. A 66-year-old patient presented with hypotension and shortness of breath. Initial chest X-ray in the emergency room showed a right-sided hydropneumothorax requiring chest tube placement. Later on, the patient was transferred to the medical intensive care unit for respiratory failure. Chest tube drainage was initially serosanguineous but later changed to milky-white drainage. Pleural fluid analysis showed a triglyceride level of 208, confirming chylothorax. Conservative treatment was initiated with a low-fat diet and octreotide. The plan was to schedule the patient for thoracic duct embolization in view of continuous chylous drainage, but due to family preference, the procedure was deferred. This case report provides an overview of chylothorax, including etiologies and diagnostic options, and shows the importance of taking a multidisciplinary approach to finalize management strategies.

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Chylothorax as a complication of extensive spontaneous left arm DVT

Cited by 2 publications

References 21 publications

Vena Cava Thrombosis after Congenital Diaphragmatic Hernia Repair: Multivariate Analysis of Potential Risk Factors

Vena Cava Thrombosis after Congenital Diaphragmatic Hernia Repair: Multivariate Analysis of Potential Risk Factors

A Unique Case of Chylothorax Occurring Post-Chest Tube Insertion

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