[Relapse of idiopathic chylothorax 17 years after remission of congenital chylothorax].
We report a case of chylothorax in a 17-year-old male. As a neonate, had had congenital chylothorax, and was successfully treated with medium-chain triglycerides; but recently presented with dyspnea after an episode of severe coughing. Radiographic examination disclosed abundant effusion in the right chest. The effusion was milky brown, had a creamy supernatant and a high triglyceride level (3085 mg/dl). This condition was diagnosed as idiopathic chylothorax. Lymphangiography showed a rupture of the right thoracic duct. Since the effusion was resistant to conservative therapy, we performed thoracoscopic clipping of the thoracic duct, which reduced the amount of pleural effusion. We speculated that coughing may have caused the rupture of a congenitally weakened thoracic duct.
Nagai
K
K
Department of Respiratory Medicine, Nikko Memorial Hospital, Muroran.
Takekawa
H
H
Shinano
H
H
D000293:Adolescent; D002916:Chylothorax / Q000151:congenital* / Q000601:surgery; D006801:Humans; D008297:Male; D012008:Recurrence; D013897:Thoracic Duct / Q000293:injuries / Q000601:surgery