Aetiology and management of chylothorax in adults.
Though rare in incidence, chylothorax can lead to significant morbidity and mortality. Its occurrence corresponds to increased mortality following esophagectomy. Leakage of chyle and lymph leads to significant loss of essential proteins, immunoglobulins, fat, vitamins, electrolytes and water. The presence of chylomicrons and a triglyceride level >110 mg/dl in the aspirated pleural fluid confirms the diagnosis of chylothorax. Identifying the aetiology using different diagnostic tests is important in planning treatment. While therapeutic thoracentesis provides relief from respiratory symptoms, the nutritional deficiency will continue to persist or deteriorate unless definitive therapeutic measures are instituted to stop leakage of chyle into the pleural space. Definitive therapy consists of obliteration and prevention of recurrence of chylothorax. Aggressive surgical therapy is recommended for post-traumatic or post-surgical chylothorax.
Nair
Sukumaran K
SK
Department of Cardiothoracic Surgery, The Heart Hospital, University College London NHS Trust, 16-18 Westmoreland Street, London W1G 8PH, United Kingdom. suku50@hotmail.com
Petko
Matus
M
Hayward
Martin P
MP
D000328:Adult; D000465:Algorithms; D002784:Cholesterol / Q000032:analysis; D002913:Chyle / Q000378:metabolism; D002916:Chylothorax / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008208:Lymphatic System / Q000033:anatomy & histology; D010996:Pleural Effusion / Q000378:metabolism; D011379:Prognosis; D019616:Thoracic Surgical Procedures / Q000379:methods; D013909:Thorax / Q000033:anatomy & histology
D002784:Cholesterol