Chylothorax Clinical Presentation

Updated: May 16, 2017
  • Author: Sasha D Adams, MD; Chief Editor: BS Anand, MD  more...
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Presentation

History and Physical Examination

History

Usually, patients with chylothorax remain asymptomatic until a large amount of chyle accumulates in the pleural space.

The average latent period between the insult and the onset of symptoms is 7-10 days. Symptoms include the following:

Rarely, patients may experience a rapid accumulation of fluid in the pleural space, causing a tension chylothorax. This is of particular concern following a pneumonectomy. These patients experience a rapid hemodynamic and respiratory compromise, similar to the classic tension pneumothorax.

Physical Examination

Findings on physical examination are nonspecific and include the following:

  • Decreased breath sounds
  • Shifting dullness

If the patient has an existing chest tube, drainage of 400-600 cc per 8-hour period is concerning for a chylous leak, particularly in postsurgical patients.