Resolution of refractory chylothorax with a combination of talc pleurodesis and CPAP

Boon Hau Ng; Nik Nuratiqah Nik Abeed; Mohamed Faisal Abdul Hamid; Chun Ian Soo; Hsueh Jing Low; Andrea Yu-Lin Ban

doi:10.1002/rcr2.624

Resolution of refractory chylothorax with a combination of talc pleurodesis and CPAP

Respirol Case Rep. 2020 Jul 15;8(7):e00624. doi: 10.1002/rcr2.624. eCollection 2020 Oct.

Authors

Boon Hau Ng¹, Nik Nuratiqah Nik Abeed¹, Mohamed Faisal Abdul Hamid¹, Chun Ian Soo¹, Hsueh Jing Low², Andrea Yu-Lin Ban¹

Affiliations

¹ Pulmonology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.
² Department of Anaesthesiology and Critical Care, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.

Abstract

Chylothorax is an uncommon cause of pleural effusion. Recurrent chylous effusions are often resistant to conservative treatment and many need surgical intervention. We report a 69-year-old woman with refractory idiopathic chylothorax resistant to medium-chain triglyceride diet and intermittent thoracentesis. Lymphangiography and lymphoscintigraphy failed to identify the site of leakage. We initiated continuous positive airway pressure (CPAP) 12 h before and 48 hours after talc pleurodesis. Chest drain was removed at day 3 and she was discharged at day 5. To our knowledge, this is the first case of successful resolution of idiopathic refractory chylothorax with CPAP ventilation used in tandem with talc pleurodesis.

Keywords: CPAP; Chylothorax; refractory; talc pleurodesis.

Publication types

Case Reports