A stepwise approach for the management of bilateral chylothoraxes from cisterna chyli trauma
Chylothorax is a rare complication characterized by chyle accumulation in the pleural space, leading to respiratory and nutritional deficits. We present a 53-year-old male who developed bilateral high-output chylothorax following radical nephrectomy and lymph node dissection for renal cell carcinoma...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007125000541 |
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| Summary: | Chylothorax is a rare complication characterized by chyle accumulation in the pleural space, leading to respiratory and nutritional deficits. We present a 53-year-old male who developed bilateral high-output chylothorax following radical nephrectomy and lymph node dissection for renal cell carcinoma. Despite conservative management with a fat-free diet, total parenteral nutrition, and octreotide, chyle output remained >1L/day. Lymphangiography identified thoracic duct leakage, but embolization and cisterna chyli fenestration were unsuccessful. The patient ultimately underwent video-assisted thoracoscopic surgery (VATS) with talc pleurodesis, resulting in resolution. This case highlights the importance of a multidisciplinary, stepwise approach in managing refractory chylothorax, with VATS and talc pleurodesis as effective interventions when conservative therapies fail. |
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| ISSN: | 2213-0071 |