eMedicine Specialties > Gastroenterology > Systemic Disease
Chylothorax: Follow-up
Updated: Aug 24, 2009
Follow-up
Complications
- Malnutrition
- Immunosuppression
Miscellaneous
Medicolegal Pitfalls
- The timing of surgical management is controversial and depends on the etiology of the chylothorax and the patient's overall condition.
- Patients with postesophagectomy chylothorax have a 50-82% mortality rate if treated conservatively.
- A malignant etiology of the chylothorax must be ruled out, as greater than 50% of cases are due to malignancy, of which lymphoma accounts for approximately 75% of cases, followed by lung carcinoma.
More on Chylothorax |
| Overview: Chylothorax |
| Differential Diagnoses & Workup: Chylothorax |
| Treatment & Medication: Chylothorax |
Follow-up: Chylothorax |
| Multimedia: Chylothorax |
| References |
| Further Reading |
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References
Ergaz Z, Bar-Oz B, Yatsiv I, Arad I. Congenital chylothorax: clinical course and prognostic significance. Pediatr Pulmonol. Aug 2009;44(8):806-11. [Medline].
Milonakis M, Chatzis AC, Giannopoulos NM, Contrafouris C, Bobos D, Kirvassilis GV, et al. Etiology and management of chylothorax following pediatric heart surgery. J Card Surg. Jul-Aug 2009;24(4):369-73. [Medline].
Paul S, Altorki NK, Port JL, Stiles BM, Lee PC. Surgical management of chylothorax. Thorac Cardiovasc Surg. Jun 2009;57(4):226-8. [Medline].
Panthongviriyakul C, Bines JE. Post-operative chylothorax in children: an evidence-based management algorithm. J Paediatr Child Health. Dec 2008;44(12):716-21. [Medline].
Nath DS, Savla J, Khemani RG, Nussbaum DP, Greene CL, Wells WJ. Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann Thorac Surg. Jul 2009;88(1):246-51; discussion 251-2. [Medline].
Ammori JB, Pickens A, Chang AC. Tension chylothorax. Ann Thorac Surg. Aug 2006;82(2):729-30.
Browse NL, Allen DR, Wilson NM. Management of chylothorax. Br J Surg. Dec 1997;84(12):1711-6. [Medline].
Clarke SA, Lakhoo K, Sherwood W. Somatostatin for intractable postoperative chylothorax in a premature infant. Pediatr Surg Int. May 2005;21(5):390-1. [Medline].
Hillerdal G. Chylothorax and pseudochylothorax. Eur Respir J. May 1997;10(5):1157-62. [Medline].
Maskell NA, Butland RJ. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax. May 2003;58 Suppl 2:ii8-17.
Merrigan BA, Winter DC, O'Sullivan GC. Chylothorax. Br J Surg. Jan 1997;84(1):15-20. [Medline].
Mohseni-Bod H, Macrae D, Slavik Z. Somatostatin analog (octreotide) in management of neonatal postoperative chylothorax: is it safe?. Pediatr Crit Care Med. Jul 2004;5(4):356-7. [Medline].
Ogi S, Fukumitsu N, Uchiyama M. A case of chylothorax diagnosed by lymphoscintigraphy using Tc-99m HSA-DTPA. Clin Nucl Med. Jun 2002;27(6):455-6. [Medline].
Paes ML, Powell H. Chylothorax: an update. Br J Hosp Med. May 4-17 1994;51(9):482-90. [Medline].
Postma GN, Keyser JS. Management of persistent chylothorax. Otolaryngol Head Neck Surg. Feb 1997;116(2):268-70. [Medline].
Rice TW, Milstone AP. Chylothorax as a result of chronic lymphocytic leukemia: case report and review of the literature. South Med J. Mar 2004;97(3):291-4. [Medline].
Sieczka EM, Harvey JC. Early thoracic duct ligation for postoperative chylothorax. J Surg Oncol. Jan 1996;61(1):56-60. [Medline].
Valentine VG, Raffin TA. The management of chylothorax. Chest. Aug 1992;102(2):586-91. [Medline].
Vallieres E, Shamji FM, Todd TR. Postpneumonectomy chylothorax. Ann Thorac Surg. Apr 1993;55(4):1006-8. [Medline].
Wemyss-Holden SA, Launois B, Maddern GJ. Management of thoracic duct injuries after oesophagectomy. Br J Surg. Nov 2001;88(11):1442-8. [Medline].
Further Reading
Related eMedicine Topics
- Chyle Fistula [in the General Surgery section]
- Effusion, Pleural [in the Radiology section]
- Pleural Effusion [in the Emergency Medicine section]
- Pleural Effusion [in the Pediatrics: General Medicine section]
Clinical Trials
- Efficacy and Safety of Sirolimus for Treating Lymphangioleiomyomatosis (LAM)
- Measurement of Hormonal Concentration in Chylothorax Fluid in Infants With Congenital Chylothorax
National Guideline Clearinghouse
- ACR Appropriateness Criteria® acute respiratory illness. American College of Radiology - Medical Specialty Society. 1995 (revised 2008). 7 pages. NGC:007012
Keywords
chylothorax, pleural effusion, pediatric chylothorax, neonatal chylothorax, thoracic duct leak, thoracic duct ligation, pleural chyle, pleural space, lymphoma, pleuroperitoneal shunt, pleurodesis, pleurectomy, chyle, postesophagectomy chylothorax, thoracentesis, lymphatic fluid, thoracic duct injury, loculated chylothorax
Follow-up: Chylothorax