What is chylothorax?

Chylothorax is the presence of lymphatic fluid in the pleural cavity, i.e. between the chest wall and the lungs. It is considered an uncommon form of pleural effusion. It can be traumatic or non-traumatic, depending on the cause.

Disease prognosis

The disease will have a good prognosis when the appropriate treatment is followed correctly.

Milky fluid extracted from a patient suffering from chylothorax

Symptoms of chylothorax

The symptoms that the patient may suffer from will be similar to those of pleural effusion. Symptoms depend on the size of chylothorax and the underlying cause. A small chylothorax may cause no symptoms, but a larger one can lead to breathlessness, pressure in the chest, reduced breathing sounds on the affected side, low blood pressure and a loss of nutrients, leading to malnutrition.

Medical tests for chylothorax

The specialist will perform a chest X-ray, and may use a technique called thoracentesis (to extract fluid or air from the pleural space) to evaluate the milky-looking, fat-rich fluids. Finally, studies of electrolytes, proteins and lipids in the blood may show the progressive depletion of certain blood nutrients.

What are the causes of chylothorax?

There are different causes of chylothorax, which can include:

• Trauma after thoracic surgery
• Tumours or lymphomas
• Noonan syndrome
• Lymphangiomatosis
• Thrombosis of the thoracic duct

In many cases, the cause of this disease is not clear.

Can it be prevented?

There is no prevention for chylothorax. The only form of prevention is to use necessary safety measures to avoid accidents or injuries to the chest.

Treatments for chylothorax

Treatment may vary depending on the cause of the disease.

Non-surgical techniques include:

• Thoracentesis or drainage of the lymphatic fluid that is trapped in the pleural cavity.
• Diet modification to reduce the circulation of lymph through the thoracic duct.
• Embolisation of the thoracic duct to block the circulation of lymphatic fluid.

As indicated above, some cases may require surgical repair.

What specialist treats it?

A thoracic surgeon treats the chylothorax.