Chylothorax: pathophysiology, diagnosis, and management—a comprehensive review

• DOI: 10.21037/jtd-23-1636
• Publication Date: 2024-02-23T09:02:00Z
• Authors: Malvika Bhatnagar; Annette Fisher; Sudarshan Ramsaroop; Alison Carter; Benjamin Pippard
• Keywords: Chylothorax; Chyle; Etiology

Chylothorax is a rare condition characterized by the accumulation of chyle in pleural space.While it accounts for small percentage effusions, chylothorax can lead to significant morbidity and mortality.This article provides comprehensive overview chylothorax, covering its relevant anatomy, aetiology, pathophysiology, clinical features, diagnosis, management.Injury or disruption thoracic duct (which responsible transport) leads development chylothorax.This may result from trauma, such as iatrogenic injury during surgery, non-traumatic causes, including malignancy, lymphatic disorders, heart failure.Recognition underlying cause essential tailor management.Clinical presentation varies, with symptoms linked rate causative condition.Diagnosis relies on fluid analysis, demonstration elevated triglyceride levels (>110 mg/dL) reduced cholesterol (<200 being key diagnostic criteria employed practice.Various imaging modalities, computed tomography (CT) scans lymphatic-specific investigations, be utilised aid identification site leak, well determine likely cause.Chylothorax management multifaceted, conservative approaches dietary modification pharmacological interventions often initiated first-line treatment.Drainage chylous effusion necessary symptom relief.When methods fail, interventional procedures like ligation embolization considered.Due diverse aetiological factors patient characteristics associated individualized strategies are recommended.Nonetheless, an evolving field paucity high-quality evidence standardized guidelines, highlighting importance ongoing research multidisciplinary approach optimize individual care.