Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax

Background Chylothorax, defined as the accumulation of chyle in the pleural space, is a rare but significant cause of pleural effusion. Its causes can be broadly classified into traumatic and non-traumatic, for which majority are from surgeries, most often cardiothoracic surgery, due to damage of th...

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Main Authors: Yingqi Wang, Isaac Fong, Anthony Yii
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Proceedings of Singapore Healthcare
Online Access:https://doi.org/10.1177/20101058251365299
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author Yingqi Wang
Isaac Fong
Anthony Yii
author_facet Yingqi Wang
Isaac Fong
Anthony Yii
author_sort Yingqi Wang
collection DOAJ
description Background Chylothorax, defined as the accumulation of chyle in the pleural space, is a rare but significant cause of pleural effusion. Its causes can be broadly classified into traumatic and non-traumatic, for which majority are from surgeries, most often cardiothoracic surgery, due to damage of the thoracic duct and its tributaries. Chylothorax after retroperitoneal surgery, such as nephrectomy, is exceptionally rare, and so far has only been reported in a few case reports. Research design Here we present a case of a 67-year-old female with hyperlipidemia who developed chylothorax after an uncomplicated left robot-assisted partial nephrectomy for renal angiomyolipoma. On postoperative day 2 (POD2), she developed pleuritic chest pain and a left-sided pneumothorax, followed by increasing pleural effusion. A chest drain was inserted on POD5, and pleural fluid analysis revealed a chylous effusion with a triglyceride level of 15 mmol/L. The effusion was managed with dietary fat restriction, octreotide therapy, and pleural drainage. The chest drain was removed on POD15 after the drainage volume decreased to <30 mL/day for two consecutive days, and no recurrence was observed. Given the negative clinical, biochemical and imaging features for malignancy and lack of cystic lung disease and low VEGF-D level inconsistent with Lymphangioleiomyomatosis (LAM), nephrectomy was considered the most likely cause for the chylothorax. Conclusion This case highlights the importance of early diagnosis and a multidisciplinary approach in managing postoperative chylothorax, even in rare instances following retroperitoneal surgery.
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spelling doaj-art-47de4404a4cb4bcab47b09c0befef86f2025-08-20T03:34:18ZengSAGE PublishingProceedings of Singapore Healthcare2059-23292025-07-013410.1177/20101058251365299Chylothorax following partial nephrectomy – A case report of a rare cause of chylothoraxYingqi WangIsaac FongAnthony YiiBackground Chylothorax, defined as the accumulation of chyle in the pleural space, is a rare but significant cause of pleural effusion. Its causes can be broadly classified into traumatic and non-traumatic, for which majority are from surgeries, most often cardiothoracic surgery, due to damage of the thoracic duct and its tributaries. Chylothorax after retroperitoneal surgery, such as nephrectomy, is exceptionally rare, and so far has only been reported in a few case reports. Research design Here we present a case of a 67-year-old female with hyperlipidemia who developed chylothorax after an uncomplicated left robot-assisted partial nephrectomy for renal angiomyolipoma. On postoperative day 2 (POD2), she developed pleuritic chest pain and a left-sided pneumothorax, followed by increasing pleural effusion. A chest drain was inserted on POD5, and pleural fluid analysis revealed a chylous effusion with a triglyceride level of 15 mmol/L. The effusion was managed with dietary fat restriction, octreotide therapy, and pleural drainage. The chest drain was removed on POD15 after the drainage volume decreased to <30 mL/day for two consecutive days, and no recurrence was observed. Given the negative clinical, biochemical and imaging features for malignancy and lack of cystic lung disease and low VEGF-D level inconsistent with Lymphangioleiomyomatosis (LAM), nephrectomy was considered the most likely cause for the chylothorax. Conclusion This case highlights the importance of early diagnosis and a multidisciplinary approach in managing postoperative chylothorax, even in rare instances following retroperitoneal surgery.https://doi.org/10.1177/20101058251365299
spellingShingle Yingqi Wang
Isaac Fong
Anthony Yii
Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax
Proceedings of Singapore Healthcare
title Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax
title_full Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax
title_fullStr Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax
title_full_unstemmed Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax
title_short Chylothorax following partial nephrectomy – A case report of a rare cause of chylothorax
title_sort chylothorax following partial nephrectomy a case report of a rare cause of chylothorax
url https://doi.org/10.1177/20101058251365299
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AT anthonyyii chylothoraxfollowingpartialnephrectomyacasereportofararecauseofchylothorax