Nontraumatic Chylothorax: Diagnostic Algorithm and Treatment Options

Nadolski, Gregory J.

doi:10.1053/j.tvir.2016.10.008

Cited by 40 publications

(29 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thirty percent are due to malignancy; lymphoma accounts for 70-75% of malignant cases (11). While there are no consensus guidelines on how to treat chylothoraces, many authors agree that first line treatment is conservative management with thoracentesis or chest tube drainage, fat free or medium chain triglyceride diet, and consideration of somatostatin or octreotide (1,5,11,(27)(28)(29). Although somatostatin or octreotide are used at many institutions, data regarding indications & efficacy of these medications are limited and/or inconsistent -some institutions use these medications at the beginning of treatment, others only if/when initial management has failed (5,27).…”

Section: Discussionmentioning

confidence: 99%

Infected chylothorax: a case report and review

Eubank¹,

Gabe²,

Kraft³

et al. 2018

Southwest J Pulm Crit Care

View full text Add to dashboard Cite

Infected chylothorax is a rare complication of a rare pathology with limited literature entirely consisting of case reports, meeting abstracts, and letters to the editor. The case of a 56-year-old male with a spontaneous infected chylothorax successfully treated and discharged to home without any residual effects is described. A systematic review of the literature revealed 11 prior cases of infected chylothoraces. Their etiologies (when known), initial pleural fluid values, and treatment are described. These cases show that while infected chylothorax has a varied presentation and affects a broad range of patients, conservative management including antibiotics, pleural fluid drainage, and symptomatic relief is a safe and appropriate starting point.

show abstract

Section: Discussionmentioning

confidence: 99%

Infected chylothorax: a case report and review

Eubank¹,

Gabe²,

Kraft³

et al. 2018

Southwest J Pulm Crit Care

View full text Add to dashboard Cite

show abstract

“…Lymphatic imaging has played a central role in elucidating the pathophysiology of several of these conditions in recent years so that targeted treatment options became available. 43 Both nodal DCE-MRL and tMRL can be employed in patients with nontraumatic chylous effusions to visualize the individual lymphatic pathology (►Fig. 8).…”

Section: Nontraumatic Chylothorax/chylopericardium/ Chylous Ascitesmentioning

confidence: 99%

Nodal and Pedal MR Lymphangiography of the Central Lymphatic System: Techniques and Applications

Pieper

2020

Semin intervent Radiol

View full text Add to dashboard Cite

Novel lymphatic imaging and interventional techniques are increasingly used in the diagnostic workup and treatment of pathologies of the central lymphatic system and have opened a new field of interventional radiology. The mainstay of lymphatic imaging today is magnetic resonance lymphangiography (MRL). It provides information on the anatomy of the central lymphatic system, lymphatic flow, as well as lymphatic pathologies and therefore is a valuable tool for treatment planning. There are two techniques to perform contrast-enhanced MRL: nodal dynamic contrast-enhanced MRL (nodal DCE-MRL) and interstitial transpedal MRL (tMRL). Nodal DCE-MRL yields superior information on lymphatic flow dynamics and is therefore best suited for suspected lymphatic flow pathologies and lymphatic malformations. tMRL is a technically simpler alternative for central lymphatic visualization without the need for sonographically guided lymph node cannulation. This review article describes current MRL techniques with a focus on contrast-enhanced MRL, their specific advantages, and possible clinical applications in patients suffering from pathologies of the central lymphatic system.

show abstract

“…Nontraumatic etiologies include malignancy, infection, systemic diseases such as lupus erythematosus, and congenital disorders of the lymphatic system. 13 The thoracic duct transports chyle from the intestinal system and flow rate ranges from 10 to 100 mL/kg of body weight per day, or on average 2.5 L per day. 14 The thoracic duct transports 70 to 80% of ingested fat in addition to fatsoluble vitamins and proteins.…”

Section: Chylothoraxmentioning

confidence: 99%

“…Thoracic duct embolization has become a viable alternative to surgery, as it is both minimally invasive and allows for identification of the location of the chyle leak. 13 In cases of lymphatic conduction disorders or where thoracic lymphatic masses result in leakage of chyle into the pleural space, direct percutaneous obliteration of the masses or aberrant channels have been effective treatments.…”

Section: Chylothoraxmentioning

confidence: 99%