Idiopathic chylothorax in a young man

Abstract

SummaryChylothorax refers to the presence of chyle in the pleural space owing to disruption or obstruction of the thoracic duct or one of its tributaries. We present a case of non-traumatic, idiopathic chylothorax in an 18-year-old man. Lymphoscintigraphy was used to identify the site of leak. We tried the full armamentarium of available non-surgical therapy on him, including a modified diet, chest tube insertion, total parenteral nutrition and octreotide. Yet, despite optimal medical therapy, his effusion continued to persist. He eventually required thoracic duct ligation, which resulted in resolution of the effusion. BACKGROUND

Intravascular Stent Implantation as Effective Therapy for Refractory Chylothorax Secondary to Congenital Superior Vena Cava Stenosis in an Infant

“…Alternatively, a ratio of cholesterol-to-triglycerides in pleural fluid of less than 1 is also diagnostic [11]. Chylothorax without a clear underlying cause (e.g., trauma, obstruction, or post-surgical damage) accounts for 5-10% of cases and is typically diagnosed on lymphangiography or lymphoscintigraphy [12].…”

Chylothorax associated with pulmonary compressive atelectasis in an emperor tamarin (Saguinus imperator)

“…Idiopathic chylothorax have been described in dogs, cats, humans, and rabbits 4–7 . In non‐human primates, a case of chylopericardium in an Alaotra bamboo lemur ( Hapalemur alaotrensis ) has been reported 8 .…”

“…2,3 Idiopathic chylothorax have been described in dogs, cats, humans, and rabbits. [4][5][6][7] In non-human primates, a case of chylopericardium in an Alaotra bamboo lemur (Hapalemur alaotrensis) has been reported. 8 Furthermore, chylothorax has been described in 13 rhesus macaques (Macaca mulatta) that developed respiratory distress and sudden death as a complication of using intravenous catheters.…”

Recurrent non‐traumatic idiopathic chylothorax: a diagnostic dilemma with therapeutic challenge

“…Malignancy, trauma, and infections such as tuberculosis and filariasis can result in chylothorax. The chyle is an odourless and white liquid; however, around 50% of chylothorax is not milky (serosanguineous) and 10% of chylothorax is idiopathic which can pose a diagnostic dilemma [1]. We propose to include pleural fluid triglycerides and cholesterol in systematic approach for all undiagnosed pleural effusion.…”