• Journal of Trauma and Injury
• /
• v.29 no.3
• /
• pp.89-92
• /
• 2016

Non-surgical traumatic chylothorax following blunt chest trauma is rare, with only a few cases having been reported. In general, conservative treatment measures are recommended as initial management of traumatic chylothorax; these include closed thoracostomy, dietary restriction, and parenteral nutrition. There are few reports of surgery for traumatic chylothorax. We report our experience with thoracic duct ligation using video-assisted thoracoscopic surgery in a patient with chylothorax following blunt chest injury with associated fractures of the thoracic spine.

• Journal of Veterinary Clinics
• /
• v.35 no.6
• /
• pp.299-301
• /
• 2018

A 7-year-old intact female Shih-Tzu with chylothorax was presented. Percutaneous popliteal computed tomographic lymphangiography was performed to evaluate the thoracic duct and seek any potential cause of chylothorax. Despite two attempts, visualization of the thoracic duct failed and perianal subcutaneous computed tomographic lymphangiography with injection of iodinated, nonionic water-soluble contrast medium (0.6 ml/kg) was performed. A single branch of intact thoracic duct and dilated and tortuous lymphatics were detected. It was diagnosed as idiopathic chylothorax. Perianal subcutaneous lymphangiography is considered a less-invasive, easy and reliable method to visualize lymphatics in patients with chylothorax.

• Journal of Chest Surgery
• /
• v.55 no.1
• /
• pp.91-94
• /
• 2022

Chylothorax after thoracic surgery is a rare complication, and treatment for refractory chylothorax is challenging. We report a case of chylothorax after cardiothoracic surgery in an infant after failure of conservative management and thoracic duct ligation. The patient underwent chemical pleurodesis with a Viscum album extract. The treatment was successful and chylothorax did not recur.

• Journal of Chest Surgery
• /
• v.53 no.2
• /
• pp.41-48
• /
• 2020

Background: Chylothorax after congenital heart surgery is not an uncommon complication, and it is associated with significant morbidity. However, consensus treatment guidelines are lacking. To improve the treatment outcomes of patients with postoperative chylothorax, we implemented a standardized management protocol at Severance Hospital in September 2014. Methods: A retrospective review of patients treated at a single center was done. All corrective and palliative operations for congenital heart disease performed at our institution between January 2008 and April 2018 were reviewed. The incidence and treatment outcomes of postoperative chylothorax were analyzed. Results: The incidence of chylothorax was 1.9%. Sixty-one percent of the patients could be managed with a low-fat diet, while 28% of the patients required complete restriction of enteral feeding. Thoracic duct embolization was performed in 2 patients and chest tube drainage decreased immediately after the procedure. No patient required thoracic duct ligation or pleurodesis. After implementation of the institutional management protocol, the number of chest tube drainage days decreased (median, 24 vs. 14 days; p=0.45). Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice protocol helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax.

• Korean Journal of Head & Neck Oncology
• /
• v.22 no.2
• /
• pp.179-182
• /
• 2006

Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Early diagnosis of chylothorax is important due to the consequences on metabolic & cardiopulmonary conditions. This present report describes our recent experiences with two cases of bilateral chylothorax following left modified radical neck dissection that was treated successfully by conservative management.

• Journal of Chest Surgery
• /
• v.22 no.5
• /
• pp.731-738
• /
• 1989

The development of chylothorax and chylopericardium are serious and often life-threatening clinical entity. The ideal treatment of these problems is not well established to date. We reviewed our experiences with chylothorax or chylopericardium in 16 patients [17 cases] from July 1979 to May 1989. Ages ranged from 20 days to 41 years. The etiologies were traumatic in 10, congenital or idiopathic in 5, and tuberculous lymphadenopathy in one. In 8 patients, the chylothorax or chylopericardium occurred as a complication of cardiothoracic surgery. Eleven patients were treated nonoperatively with either repeated thoracenteses or chest tube drainage. Five patients underwent operative treatment: transthoracic thoracic duct ligation [three patients], thoracic duct ligation combined with decortication [one], and oversewn the defect of mediastinal pleura[one]. Duration of preoperative therapy ranged from 18 to 38 days. One of eleven [9.1 %] patients treated nonoperatively died. Of the surgically treated group, there were no deaths. All patients except one dead cured or improved either treated nonoperatively or operatively. Our experience suggests that surgical management of the chylothorax or chylopericardium is not always required, and each patient must be judged individually according to disease process.

• Archives of Plastic Surgery
• /
• v.49 no.4
• /
• pp.549-553
• /
• 2022

Chylothorax is a rare disease and massive lymph fluid loss can cause life-threatening condition such as severe malnutrition, weight loss, and impaired immune system. If untreated, mortality rate of chylothorax can be up to 50%. This is a case report of a 3-year-old child with iatrogenic chylothorax. Despite conservative treatment and procedures, like perm catheter insertion, the patient failed to improve the respiratory symptoms over 3 months of period. As an alternative to surgical option, such as pleurodesis and thoracic duct ligation which has high complication rate, the patient underwent lymphovenous anastomosis (LVA) and lymph node to vein anastomosis (LNVA). Follow-up at fourth month showed clear lungs without breathing difficulty despite perm catheter removal. This is the first report to show the effectiveness of LVA and LNVA against iatrogenic chylothorax.

• Journal of Chest Surgery
• /
• v.52 no.6
• /
• pp.409-415
• /
• 2019

Background: Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax. Methods: We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]). Results: The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively). Conclusion: This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

• Journal of Yeungnam Medical Science
• /
• v.34 no.2
• /
• pp.265-269
• /
• 2017

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

• Journal of Chest Surgery
• /
• v.29 no.6
• /
• pp.672-674
• /
• 1996

Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.