What is Chylothorax?
Chylothorax is the accumulation of lymphatic fluid in the pleural space (the thin space between the lung and the chest cavity).
The lymphatic system circulates lymphatic fluid from all over the body to the thoracic cavity where the lymphatic ducts travel through. When there is a disruption to this transport system, this fluid can leak into the pleural cavity leading to chylothorax.
If left untreated, the condition can turn fatal.
Causes of Chylothorax
There is a variety of causes for chylothorax:
- Traumatic injuries (most common cause)
- Systemic infections such as tuberculosis
What are the Symptoms of Chylothorax
Some cases may be asymptomatic or may occur as incidental findings. Symptoms may present as shortness of breath if there is a very large volume of fluid accumulation. History of surgery or traumatic injury may also help with the diagnosis.
This imaging test helps to pinpoint the amount of fluid that has accumulated in the chest.
This is another imaging test that can quantitatively assess the amount of fluid resent in the pleural space. It also allows a conclusion to be drawn on the degree of compressive symptoms along with any other lung conditions that may have been previously undetected.
A chest tube will be inserted into the pleural cavity to remove the lymphatic fluid. This will help the lung expand. The fluid collected will be sent for analysis.
As previously mentioned, the fluid will be sent for biochemical analysis. It will usually be found with a high composition of cholesterol which causes the white (milky) colour of the fluid.
The management of Chylothorax is usually divided into 3 primary phases:
- Treating the underlying condition
- Medical or Conservative Management
- The doctor would require the patient to be fasted before carrying out an intercostal chest drain. Other forms of medication will be administered directly into the bloodstream.
- Surgical Management
There are a few procedures that can be undertaken namely the robotic-assisted/ video-assisted/ open thoracic surgery to completely seal the thoracic duct. In rare cases, a shunt may be done to allow the drainage of the fluid to another part of the body.
The surgeon will discuss options with you as to what will be suitable for your case.