Resolution of refractory chylothorax with a combination of talc pleurodesis and <scp>CPAP</scp>

Ng, Boon Hau; Abeed, Nik Nuratiqah Nik; Hamid, Mohamed Faisal Abdul; Soo, Chun Ian; Low, Hsueh Jing; A, Bán

doi:10.1002/rcr2.624

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Ligation of the thoracic duct above the right hemidiaphragm has reported higher success rates and halts flow from unidentified accessory ducts 13 14. Talc pleurodesis is an alternative option when the thoracic duct is unidentifiable, with successful cases of idiopathic chylothorax reported without surgical intervention 15…”

Section: Discussionmentioning

confidence: 99%

Recurrent bilateral idiopathic chylothorax: a therapeutic challenge

Ng,

Ban,

Nik Abeed

et al. 2023

BMJ Case Rep

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Chylothorax is a rare condition caused by pleural effusion resulting from thoracic duct injury. Recurrent chylothorax is often resistant to conservative treatment and presents a clinical conundrum in its management. Here, we report a compelling case of recurrent chylothorax that persisted despite the administration of total parenteral nutrition, octreotide and thoracic duct embolisation. The patient eventually required thoracic duct ligation and talc pleurodesis, which resulted in the resolution of the effusion. Our case is an illustrative example of the effective multidisciplinary management of recurrent bilateral idiopathic chylothorax.

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Section: Discussionmentioning

confidence: 99%

Recurrent bilateral idiopathic chylothorax: a therapeutic challenge

Ng,

Ban,

Nik Abeed

et al. 2023

BMJ Case Rep

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“…When conservative treatments fail, it is necessary to perform other procedures, such as talc pleurodesis or pleuroperitoneal shunt [105,107,116]. Nonetheless, rapidly recurrent chylous effusions are often resistant to conservative treatment and many need surgical intervention [117].…”

Section: Complicationsmentioning

confidence: 99%

Pulmonary Kaposi Sarcoma without Respiratory Symptoms and Skin Lesions in an HIV-Naïve Patient: A Case Report and Literature Review

Micali

Russotto

Facciolà

et al. 2022

Infectious Disease Reports

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Kaposi sarcoma (KS) is a multifocal lympho-angioproliferative, mesenchymal low-grade tumor associated with a γ2-herpesvirus, named Kaposi sarcoma-associated virus or human herpesvirus (KSHV/HHV8). The lung is considered a usual anatomical location of KS, despite being infrequent, often in association with extensive mucocutaneous lesions and very uncommonly as an isolated event. We report a case of a pulmonary KS (pKS) in a human immunodeficiency virus (HIV) naïve patient, which was atypical due to a lack of cutaneous involvement and an absence of respiratory symptoms. The pKS was initially identified as a tumoral suspected nodular lesion and only after immunohistochemical analysis was it characterized as KS. Furthermore, the diagnosis of pKS led to the discovery of the HIV-seropositive status of the patient, previously unknown. Our report underlines the importance of considering pKS even without skin lesions and as a first manifestation of HIV infection. We also reviewed literature on the current knowledge about pKS in people living with HIV (PLWH) to underline how one of the most common HIV/acquired immunodeficiency syndrome (AIDS) associated tumors can have a challenging localization and be difficult to recognize.

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Multidisciplinary management of adult patients with chylothorax: a consensus statement

Agrawal,

Chaddha,

Shojaee

et al. 2024

Eur Respir J

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The management of chylothorax remains challenging given the limited evidence and significant heterogeneity in practice. In addition, there are no practical guidelines on the optimal approach to manage this complex condition. We convened an international group of 27 experts from 20 institutions across five countries and 4 specialties (Pulmonary, Interventional Radiology, Thoracic Surgery & Nutrition) with experience and expertise in managing adult patients with chylothorax. We performed a literature and internet search for reports addressing 7 clinically relevant questions pertaining to the management of adult patients with chylothorax. This consensus statement, consisting of best practice statements based on expert consensus addressing these 7 PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with provider experience. Panel members participated in the development of the final best practice statements using the modified Delphi technique. Our consensus statement aims to offer guidance in clinical decision making when managing patients with chylothorax while also identifying gaps in knowledge and inform future research.

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Resolution of refractory chylothorax with a combination of talc pleurodesis and CPAP

Cited by 3 publications

References 5 publications

Recurrent bilateral idiopathic chylothorax: a therapeutic challenge

Recurrent bilateral idiopathic chylothorax: a therapeutic challenge

Pulmonary Kaposi Sarcoma without Respiratory Symptoms and Skin Lesions in an HIV-Naïve Patient: A Case Report and Literature Review

Multidisciplinary management of adult patients with chylothorax: a consensus statement

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