Recurrent bilateral idiopathic chylothorax: a therapeutic challenge

BMJ Case Rep. 2023 Dec 16;16(12):e258049. doi: 10.1136/bcr-2023-258049.

Abstract

Chylothorax is a rare condition caused by pleural effusion resulting from thoracic duct injury. Recurrent chylothorax is often resistant to conservative treatment and presents a clinical conundrum in its management. Here, we report a compelling case of recurrent chylothorax that persisted despite the administration of total parenteral nutrition, octreotide and thoracic duct embolisation. The patient eventually required thoracic duct ligation and talc pleurodesis, which resulted in the resolution of the effusion. Our case is an illustrative example of the effective multidisciplinary management of recurrent bilateral idiopathic chylothorax.

Keywords: Pleural infection; Pneumonia (respiratory medicine); Pneumothorax.

Publication types

  • Case Reports

MeSH terms

  • Chylothorax* / diagnosis
  • Chylothorax* / etiology
  • Chylothorax* / therapy
  • Humans
  • Octreotide / therapeutic use
  • Pleural Effusion* / therapy
  • Pleurodesis / adverse effects
  • Thoracic Duct
  • Thoracic Injuries* / complications

Substances

  • Octreotide