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Open Access Publications from the University of California

Chylothorax: a rare complication of tube thoracostomy.

  • Author(s): Limsukon, Atikun
  • Yick, Dennis
  • Kamangar, Nader
  • et al.

BACKGROUND: Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported. OBJECTIVE: The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy. CASE REPORT: An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet. CONCLUSION: The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube.

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