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Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Chylothorax following congenital heart surgery is a potentially serious complication that requires early diagnosis and treatment. The aim of this study is to review our experience with the treatment of chylothorax occurring in the early period after congenital heart surgery. Materials and Methods: The records of patients who developed postoperative chylothorax among 1215 patients who underwent surgery for congenital heart disease in our hospital between March 2017 and February 2023 were retrospectively reviewed. Results: Seventeen patients, 11 of whom were male, who developed postoperative chylothorax were included in the study. The median age was 7.5 months, and the median body weight was 6.4 kilograms. Surgical procedures were aortic coarctation repair (five), Glenn operation (four), Tetralogy of Fallot repair (two), Fontan operation (one), atrioventricular canal defect repair (one), ventricular septal defect closure (one), vascular ring repair (one), patent ductus arteriosus ligation (one), and right modified Blalock-Taussig shunt in one patient. The median amount of lymphatic drainage was 4.6 ml/kg/day (2.3 to 8.1 ml/kg/day) and the median lymphatic drainage time was 16.5 days (5 to 38 days). After the chylous fluid drained, total parenteral nutrition and enteral medium-chain triglyceride diet were given. Octreotide was used additionally in 82.4% of the patients. After the chylous fluid drainage stopped, the patients were given a medium chain triglyceride diet for 6 weeks. One patient died due to sepsis. Conclusions: Chylothorax is a complication that causes morbidity after cardiac surgery. Morbidity can be reduced if a correct algorithm determined by the clinic is followed. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vascular anomalies are pathologies that occur in embryonic life that affect the lymphatic and capillary systems, and can be classified as vascular tumors or vascular malformations, according to their histological features. They are rare and are mostly detected in the first years of life. Hemangiolymphangiomas are benign vascular tumors containing lymphatic and capillary-system elements with a reported incidence of 1: 12,000 in newborns. The cases reported to date have been in the head (oral cavity, orbita, etc.), neck and mediastinum regions. We presented here a case of a 17-year-old male patient who was diagnosed with hemangiolymphangioma after a videoassisted lung biopsy (VATS) with accompanying interstitial lung disease. The patient, who had no history of chronic disease, presented to the outpatient clinic complaining of cough and shortness of breath for eight months. Interstitial lung features were observed in the patient's thorax computer tomography. After the VATS procedure, the patient developed chylothorax, and the pathology results indicated hemangiolymphangioma. [ABSTRACT FROM AUTHOR]

Chylothorax is defined as abnormal accumulation of lymphatic fluid in the pleural space. Chylothorax is a rare case and generally occurs after thoracic and cardiac procedures. Chylothorax causes respiratory and nutritional problems and a significant mortality rate. Good knowledge of the underlying pathophysiology enables early diagnosis and prevention of the chronic complications related to immunodeficiency and malnutrition. Octreotide is a long-acting somatostatin analog that can reduce lymphatic fluid production and has been used as a new strategy in the treatment of chylothorax. In gastrointestinal tract, somatostatin and octreotide act on somatostatin receptors to reduce intestinal blood flow by vasoconstriction of the splanchnic vessels; decrease gastrointestinal motility; and inhibit gastric, pancreatic, and biliary secretions, thus reducing intestinal fat absorption and lymphatic flow in the thoracic duct. Octreotide is generally considered to be safe, with only occasional side effects. The side effects of octreotide are mainly related to its vasoconstrictive and antisecretory actions. The general consensus is for conservative management with octreotide to be instituted for 1 week before consideration of surgery. In case of either high flow rate chylothorax, especially after oesophageal surgery, or failure of conservative treatment with octreotide, operation is indicated.

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Development of chylothorax after thoracic surgery is rare; however, it is a serious complication and is generally medically treated. In cases where medical treatment is unsuccessful, due to the course and anatomical feature of the ductus thoracicus, right supradiaphragmatic mass ligation is the method used in the surgical treatment of chylothorax generally. We present a case of 73-yearold female patient, VATS (Video Assisted Thoracic Surgery) left upper lobectomy and mediastinal lymph node dissection were performed due to lung malignancy and during the postoperative follow-up, left chylothorax developed. Left-sided thoracoscopic ductus ligation was performed no need of the second incision for right mass ligation. In the case of iatrogenic chylothorax in the left hemithorax, the left thoracoscopic approach should always be kept in mind. [ABSTRACT FROM AUTHOR]

Gorham-Stout disease is a complex disease in which lytic lesions of bone tissue are accompanied by chylothorax and abdominal lymphangioma. The etiology is still unknown. The diagnosis is made by the patient's clinical and laboratory findings and biopsy results. It may be fatal depending on the organs involved. Although many treatments have been described, successful results have been reported with interferon alpha 2b in recent years. We discuss the clinical diagnosis and treatment of a 5-year-old female patient with osteolytic lesions in the bones after she was referred with chylothorax. [ABSTRACT FROM AUTHOR]

Chylothorax is a rare condition characterized by accumulation of chylous fluid in the pleural space resulting in impaired ductus thoracic integrity. It can be an outcome of a traumatic process, although there are a few non-traumatic and/or idiopathic cases in current literature. In this article, we present the oldest case report so for, who is an 87-year-old woman complaining of acute respiratory distress symptoms with pleural effusion having no trauma history. The patient was analyzed for the disease etiology strenuously. Thoracentesis was performed together with imaging modalities and detailed systemic laboratory tests. Non-surgical treatment was successful as the outcome. [ABSTRACT FROM AUTHOR]

Waldenström's macroglobulinaemia is a disease in the B lymphoproliferative diseases group with immunoglobin M monoclonality and may present with different clinical manifestations. A 52-year-old male patient presented with complaints of weight loss and shortness of breath. Computed tomography (CT) results revealed a mass with a malignant soft tissue density in the abdomen. In the thoracic images, free fluid of up to 130 mm was found between the pleural leaves on both sides. His biopsies from the abdominal mass and bone marrow were reported to be compatible with a lymphoplasmocytic lymphoma in the presence of plasmoid differentiation B cell neoplasia and a Waldenström clinic. Cyclophosphamide -adriamycin -vincristine -prednisolone regimen was used in the first cycle chemotherapy. Positron emission tomography/CT imaging, which was performed on the 15th day after the second cycle of chemotherapy, showed that the patient's tumour was stable in size, but metabolic partial regression was observed. Bortezomib-dexamethasone-rituximab regimen was planned because of the resistant chylothorax. The patient had a dramatic clinical response and the chylothorax regressed completely after the first cure treatment. Chylothorax is a rare clinical presentation with chyle in the pleural area. It has traumatic and non-traumatic causes. Non-traumatic causes are most frequently seen due to malignancies. Waldenström's macroglobulinaemia has a very rare incidence, and the clinical association between Waldenström's macroglobulinaemia and chylothorax is very interesting. Standard treatment regimens vary, but the response to treatment also varies. Our case was resistant to the first line treatment, but had a dramatic response to the bortezomib and rituximab-based treatment. [ABSTRACT FROM AUTHOR]

Chylothorax is defined as the accumulation of lymphatic fluid in the pleural cavity. It results from congenital and acquired causes. Although the etiology of congenital chylothorax is not fully understood, it has been suggested to be a developmental disorder of the lymphatic system. Congenital chylothorax is often accompanied by hydrops fetalis. The diagnosis is made by measurement of the triglyceride level in fluid above 110 mg/dl and total cell count above 1000/ml with 80% lymphocyte. The severity of the clinical condition in chylothorax is determined by the amount of accumulated chylous fluid. Whilst some newborns are asymptomatic or have mild respiratory distress as a clinical symptom, the majority of the cases, if not treated, present with potentially life-threatening respiratory distress. Conservative and surgical methods are used in the treatment of chylothorax. Conservative therapy includes the treatment of the underlying disease, continuous drainage through repeated thoracentesis or thoracic tube, total parenteral nutrition following the suspension of enteral nutrition, and a diet containing medium chain triglycerides. Octreotide use is offered if there is no response to these methods. The two parameters used to define failure of conservative therapy are the duration and the volume of the continuing lymphatic drainage. In cases where octreotide therapy fails, chemical pleurodesis and surgical treatment should be tried. Surgical treatment includes thoracoscopic pleurodesis, surgical abrasion, pleuroperitoneal shunt placement, and thoracic ductus ligation. The prognosis of chylothorax varies depending on the underlying etiology. The prognosis of chylothorax is generally good with appropriate treatment. Nonetheless, the severity of accompanying pulmonary hypoplasia, and presence of prematurity and hydrops have been reported to be among the factors increasing mortality rate. [ABSTRACT FROM AUTHOR]

Chylothorax is a lymphatic pleurisy which is a rarely (%0.3-1.5) seen complication of cardiac surgery and can be life threatening (50% mortality) unless properly treated. This ratio is more rare after coronary bypass surgery (0.09%) than any other cardiac surgery. The conventional treatment of chylothorax is pleural drainage, enteric rest and total parenteral nutrition. The second option is percutaneouse intervention. Surgery should be preserved for patient who is resitant to the conventional and percutaneouse methods. We report the case of a 55 years old man who suffered from chylotorax after cardiac surgey, detecting in the first visit after discharge (postoperatif 9th day). The case is presented to draw attention to this rare presentation. [ABSTRACT FROM AUTHOR]

Chylothorax is the disruption or obstruction of thoracic duct as a result of trauma or neoplasms. It is a rare cause of pleural effusion characterized by high triglyceride and low cholesterol concentrations. Cyhlothoraxrelated acute respiratory distress syndrome is an uncommon condition. Herein, we report and discuss a patient who developed acute respiratory distress syndrome (ARDS) due to high flow chylothorax, which was treated by protective mechanical ventilation strategies, prolonged prone position and thoracic duct ligation. [ABSTRACT FROM AUTHOR]

Hyperhidrosis (HH) is a pathological condition of excessive secretion of the eccrine sweat glands in amounts greater than that required for physiological needs. Herein, we describe a patient who was treated with autologous blood pleurodesis for ductus thoracicus injury after endoscopic thoracic sympathectomy. A 23-year-old woman was admitted to our clinic with a complaint of bilateral pronounced axillary HH, minimal sweating of the hands, and bruising. She underwent bilateral thoracic sympathectomy at levels T3 and T4. A milky fluid was observed in the left chest tube and was diagnosed as chylothorax. No similar case of postoperative chylothorax treated with autologous blood pleurodesis has been found in the English literature. According to anatomical variations, the ductus thoracicus is susceptible to injury even in the hands of an experienced surgeon. In case an injury has occurred shortly after thoracic sympathectomy, autologous blood pleurodesis is an effective treatment for chylothorax. This procedure is safe and cheap and can be easily performed at the bedside. [ABSTRACT FROM AUTHOR]

Chylothorax is the collection of lymphatic fluid in the pleural space. Lymphatic fluid in the pleural space may cause metabolic and immunologic disorders. Trauma to the thoracic duct and malignant disease (non-Hodgkin's lymphoma) are the common mechanisms of chylothorax. Other rare causes are lymphangiomyomatosis, tuberculosis, venous thrombosis, congenital lymphatic malformations, nephrotic syndrome, hypothyroidism, cirrhosis and idiopathic chylothorax. A 56-year-old woman presented with dyspnea, reduced appetite and weight loss. A chest x-ray showed left homogenoeus density with a concave interface toward the lung and blunting of right costophrenic angle. Thoracentesis was performed. Milky off-white fluid was aspirated. Analysis of the fluid confirmed the diagnosis of chylothorax. Etiology was not determined. Chylothorax was regressed with conservative treatment. We present a case of rare bilateral-idiopathic chylothorax with regression following conservative therapy. [ABSTRACT FROM AUTHOR]

Chylothorax is a rare cause of pleural effusion in childhood. Even though the etiology of the illness varies according to age, the major causes have been reported to be congenital causes, surgical procedures, trauma, tumoral factors, idiopathic and some infectious diseases. The three pediatric cases diagnosed as chylothorax with the help of clinical and radiological findings and pleural fluid analysis presented here include a 2.5-month-old female patient (idiopathic non-immune hydrops fetalis-associated congenital chylothorax), a 3.5-month-old male patient (idiopathic chylothorax) and an 11-month old male patient (idiopathic chylothorax). All three patients recovered with medical treatment (case 1; total parenteral nutrition and formula containing medium-chain fatty acids; case 2; total parenteral nutrition and formula containing medium chain fatty acids and somatostatin; case 3; formula containing medium chain fatty acids) supplemented by chest tube drainage. No recurrence was observed in any of the cases during the follow-up period. The diagnosis of chylothorax is made through clinical findings, radiology and the analysis of pleural fluid. In cases that fail to respond to treatment with diet and total parenteral nutrition, a successful outcome can be possible with the addition of somatostatin or octreotide treatment. Surgical treatment can be used in cases resistant to medical treatment. [ABSTRACT FROM AUTHOR]

2-year-old, intact female, a Golden Retriever Dog was presented with the signs of respiratory distress, exercise intolerance, and muscular weakness. A high-grade systolic murmur was auscultated over the tricuspid valvular area. Thoracic radiographs showed an enlarged D-shape heart and free fluid (chylothorax) in the pleural space. ECG revealed small QRS complexes. Doppler echocardiography disclosed severe tricuspid insufficiency with moderate pulmonary hypertension, and tricuspid leaflets also were displaced down into the right ventricle, substantiating Ebstein's anomaly. Five-weeks after the medical therapy, patient died at home. The owner of the patient refused the necropsy. This is the first case report of tricuspid dysplasia and Ebstein's anomaly along with chylothorax in dogs. [ABSTRACT FROM AUTHOR]

Chylothorax occurs when chylous fluid from the lymphatic system accumulates in the pleural space due to damage to the ductus thoracicus. The milky fluid contains a high concentration of triglycerides in the form of chylomicrons. The initial test for diagnosis is analysis of the pleural fluid. It may be associated with a number of traumatic and nontraumatic conditions. Chylothorax was diagnosed in a patient who underwent an operation for a thoracic vertebra fracture 4 years earlier who presented with bronchitis. Fixation pins in the lower thoracic vertebra inserted in the operation were observed on thorax computerized tomography. No other etiological cause for chylothorax was found based on the patient history, physical examination, or advanced examinations. It was decided that the collapse and fracture operation had a late complication. This case is presented as an interesting etiological cause of chylothorax as, to our knowledge, there is no similar case in the literature. [ABSTRACT FROM AUTHOR]

Chylothorax is a rare condition in children with various traumatic and non traumatic etiologies. It is very important to determine the etiology for the management. Herein, we report a 16 year-old boy with a history of monosomy 7 positive refractory AML, stem cell transplantation, gastrointestinal graft versus host disease, invasive aspergillosis and bilateral chylothorax with multiple suspected etiologies. [ABSTRACT FROM AUTHOR]

Dasatinib is a potent second-generation tyrosine kinase inhibitor for the treatment of chronic myeloid leukemia. The most common adverse event associated with dasatinib therapy is fluid retention, including pleural effusion. Dasatinib-related chylothorax has rarely been reported. The clinical manifestations, pathophysiology, management, and prognosis are not fully understood. Here we report a 40-year-old woman presenting with chylothorax following dasatinib use. We propose the hypothesis of its mechanism as well as offering a review of the relevant literature. [ABSTRACT FROM AUTHOR]

Co-existence of chylothorax and chyloabdomen is a rare clinical entity. Apart from surgery and extra-surgical trauma, malignancies, liver cirrhosis, nephrotic syndrome, thrombosis in the superior vena cava and acute pancreatitis play roles in the etiology. The case presented in this article was a 35-year-old woman, and the chronic infectious pathology in the cytology, plus the other supportive nonspecific infection parameters prompted us in establishing this diagnosis. Obstruction in the abdominal lymphatics leads to chylous ascites and chylothorax develops in due course. Similar to our case, the clinical entities of chylothorax and chyloabdomen of nonspecific infectious origin may co-exist in the same patient. [ABSTRACT FROM AUTHOR]

Chylothorax due to right-sided heart failure was diagnosed in a 3.5-year-old, male Rottweiler, based on the clinical, radiological, and echocardiographic examinations, and serum biochemical test results (pleural fluid cytology and triglyceride levels of the serum and pleural fluid). En bloc ligation of thoracic duct along with its branches and pleural abrasion were performed after the failure of the initial medical management including pleural drainage via tube thoracostomy, and enalapril, furosemide, and low-fat diet (Prescription Diet Canine r/d, Hill's Pet Product, Topeka, Kansas, USA). Combination medical and surgical therapy resulted in an excellent postoperative outcome. Six months after surgery the dog had no evidence of clinical signs of right-sided heart failure or chylothorax and the severity of echocardiographic abnormalities (right atrial dilatation and tricuspid regurgitant jet velocity) was reduced. [ABSTRACT FROM AUTHOR]

Chylothorax usually results from trauma or it is developed iatrogenicaly during chest surgery procedures. Treatment should be started as soon as diagnosed and surgical treatment should be planned unless drainage is not decreased by conservative treatment for 10-14 days. Primary repair, ductal ligation and anastomosis are prefered during surgical treatment. We presented a case of 27 years old male with ductus thoracicus injury as a result of gunshot. In this case, injury was determined during thoracotomy and ligation was performed. There was not any complication during postoperative following and patient was discharged from hospital as welmpfare. [ABSTRACT FROM AUTHOR]

Chylothorax, which is a rare complication of central venous catheterization, is an accumulation of lymphatic fluid in the pleural space as a result of impairment of the integrity of ductus thoracicus. In this case report, we will look over chylothorax related to thrombus developing following subclavian vein catheterization. [ABSTRACT FROM AUTHOR]

Tetra-amelia is a very rare genetic disorder, characterized by the complete absence of all extremities. Patients often have to be hospitalized because of pulmonary infection and associated abnormalities. In this patient group, venous access is possible by the insertion of either a peripheral intracath at the scalp/neck or a central venous catheter (CVC) at the internal jugular vein. Following central venous catheterization, many complications such as vessel and nerve injury, pneumothorax, hemothorax, cardiac tamponade, pulmonary embolism, arrhythmia, sepsis, and infection at the insertion site have been reported in the English literature. Chylothorax, a rare complication following central venous catheterization, can be decreased by preferring insertion of the CVC to the right internal jugular vein and using a flexible CVC of an appropriate length and gauge. Herein, insertion of CVC in a case with tetra-amelia and diagnosis and treatment of CVC-related chylothorax were summarized. [ABSTRACT FROM AUTHOR]

A 72 year old female, who was previously investigated in another medical centre, presented with left sided pleural effusion, cough and dyspnea of three months duration. On chest roentgenogram, a left sided pleural opacity up to the level of the fourth rib was noted. On chest computerized tomography (CT), paratracheal and paraaortic lymph nodes ranging between 1-2 cm and left sided pleural effusion were determined. We performed thoracentesis. The appearance of pleural fluid was chylous. Cholesterol was 96 mg/dl, triglyceride 1750 mg/dl, LDH 253 IU/l, glucose 80 mg/dl, and albumin 3.2 gr/dl in the pleural fluid. Pleural fluid ARB was negative. There was no history of trauma, but she was complaining of severe cough at the time of initial presentation. Talc pleuredesis was performed after tube thoracostomy. Mediastinoscopy was performed 15 days after the pleuredesis to determine the diagnosis. Pathology revealed granulomatous lymphadenitis without necrosis. Tuberculin skin test was negative. We evaluated the case as sarcoidosis complicated with chylothorax. The patient was discharged for follow up. There was no progression at the end of the eighth month. The case has been presented because sarcoidosis complicated with chylothorax has been rarely reported in the literature. [ABSTRACT FROM AUTHOR]

Chylothorax is very rare clinical entity which develops by collection of lymphatic fluid in the pleural space and it may cause metabolic and immunologic disorders. The causes of chylothorax are thoracic trauma, inflammatory diseases and malign lymphatic obstruction. Also it can be congenital. Traumatic chylothorax is a rare clinical case and it can be diagnosed easily. surgery performed after waiting for more than 10-14 days. We aimed to tell this case is a case of a gunshot wound up to date information on the basis of scientific evidence. [ABSTRACT FROM AUTHOR]