Chylothorax: A review of current management strategies

Hans Lee, Rammohan Gumpeni, Mukesh Jain, Arunabh Talwar

Research output: Contribution to journalReview article

Abstract

The most common causes of chylothorax are neoplasm - particularly lymphoma - and trauma. The usual presenting symptom is dyspnea resulting from the accumulation of pleural fluid. The diagnosis of chylothorax is established by measuring triglyceride levels in the pleural fluid; a triglyceride level of greater than 110 mg/dL supports the diagnosis. The initial approach to management involves chest tube drainage of the pleural space. The administration of medium-chain triglycerides as a source of fat is often useful. If drainage remains unchanged, parenteral alimentation should be started. Surgical intervention is indicated if conservative management is not successful or if nutritional deterioration is imminent. If chylothorax persists after ligation of the thoracic duct, options may include percutaneous embolization, pleuroperitoneal shunt, and pleurodesis.

Original languageEnglish (US)
Pages (from-to)325-333
Number of pages9
JournalJournal of Respiratory Diseases
Volume29
Issue number8
StatePublished - Aug 1 2008
Externally publishedYes

Keywords

  • Chylothorax
  • Pleural effusion
  • Thoracoscopy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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  • Cite this

    Lee, H., Gumpeni, R., Jain, M., & Talwar, A. (2008). Chylothorax: A review of current management strategies. Journal of Respiratory Diseases, 29(8), 325-333.