User:Mr. Ibrahem/Chylothorax

Chylothorax is the build up of chyle, a type of lipid-rich lymph, in the space surrounding the lung. Small amounts of fluid generally result in no symptoms, while large amounts can result in shortness of breath, chest pressure, and trouble exercising. Fever or pain generally do not occur. The right side is more commonly affected than the left. Complications can include low blood volume, malnutrition, and infection.

It may occur after surgery (>50% of cases), secondary to cancer, infections, or a chest injury, or as a result of a birth defect. It occurs in about 7.5% of people after surgery to remove the esophagus and 5% of cases after lung and mediastinal lymph node removal. Cancers implicated include lymphoma, chronic lymphoid leukemia, lung cancer, and esophageal cancer. In about 10% of cases the cause is unclear. Diagnosis may be based on medical imaging and analysis of the fluid including measures for triglycerides and cholesterol. A pleural effusion high in cholesterol (known as a pseudochylothorax) may appear similar.

Management depends on the underlying cause. Efforts may include dietary changes, thoracentesis, pleurodesis, tying off the thoracic duct, and certain medications. Dietary changes involve a diet low in long-chain fatty acids. Medications used may include octreotide, midodrine, and sirolimus.

Chylothorax is a rare. About 2–3% of fluid collections surrounding the lungs are chylothoraces. Males and females are affected with similar frequency. The condition was first described in 1633 by Bartolet.