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BMJ Case Reports 2017; doi:10.1136/bcr-2017-221031
  • Rare disease
  • CASE REPORT

Rare case of massive bilateral chylothorax

  1. Yashwant Agrawal
  1. Department of Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Guramrinder Singh Thind, guramrinder.thind{at}med.wmich.edu
  • Accepted 23 August 2017
  • Published 7 September 2017

Summary

We present a case of a 48-year-old woman who was referred from an outside hospital. There, she had initially underwent hysterectomy and left salpingo-oophorectomy for tubo-ovarian abscess. She later developed a colovaginal fistula and perforation of sigmoid colon and underwent Hartmann’s procedure along with drainage of a left subphrenic abscess. Subsequently, she had to be intubated for acute respiratory failure and was transferred to our hospital. At our hospital, she was found to have massive bilateral pleural effusions. Bilateral small-bore chest tubes were inserted that drained milky fluid. Pleural fluid analysis was consistent with bilateral chylothorax. Thereafter, patient’s respiratory status improved and she was extubated. The mechanism of chylothorax was thought be either secondary to the multiple abdominal procedures or alternatively as a complication of the right subclavian catheter that was placed at the outside hospital. Her chest tubes were removed eventually, and she had a slow but definite recovery.

Footnotes

  • This case was presented at American Thoracic Society national conference in 2016 and the abstract was published in society’s journal.

  • Contributors All authors contributed to the manuscript as follows: GST and YA were both part of the intensive care unit team that admitted the patient. DMZ resumed care of the patient in the second week. Hence, all authors were directly involved with patient care. GST and DMZ did the literature review and manuscript write-up. YA revised the manuscript critically for important intellectual content. All authors gave their final approval of the version to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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