title: Spilt Milk: An Unusual Cause of Bilateral Chylothorax.
abstract: We report a case of bilateral chylothorax without evidence of chylous fistula in a 62-year-old man following total laryngectomy and bilateral selective neck dissection for laryngeal cancer. Chylous fistulae, a well-known complication of neck dissection, occurs following 1% to 2% of these surgeries. On rare occasions, the chyle leak may communicate with the pleural space, resulting in chylothorax. This is a rare but potentially life-threatening complication. Bilateral chylothorax following neck dissection is even rarer, with less than 25 cases reported in the literature. Early diagnosis is essential to prevent complications. Physicians should have a high index of suspicion, especially when the postoperative effusions do not respond to diuretics. Though no evidence-based treatment guidelines exist, expert opinion recommends conservative management as first-line therapy. Our patient was effectively treated by conservative management. We postulate a mechanism whereby bilateral chylothorax occurred in our patient without a chylous fistula.
authors.affiliation: University of New Mexico School of Medicine, Albuquerque, NM, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Matani
authors.affiliation: University of New Mexico School of Medicine, Albuquerque, NM, USA.
authors.forename: J Rush
authors.initials: JR
authors.lastname: Pierce
keywords: bilateral chylothorax; laryngectomy; neck dissection; thoracic duct