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Case report
Chylothorax post transaxillary first rib resection for thoracic outlet syndrome
  1. Sylvie Bowden1,
  2. Mohammed Firdouse2 and
  3. Graham Roche-Nagle2
  1. 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Vascular Surgery, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Graham Roche-Nagle; graham.roche-nagle{at}


We present a patient who developed high output chyle leak post left transaxillary first rib resection for venous thoracic outlet syndrome. The high output chylorrhoea was successfully treated by conservative measures, bed rest, parenteral nutrition and low-fat diet. The patient was discharged after an 18-day hospital stay with a complete resolution of his chylous fistula prior to discharge. This is the first documented chylothorax post transaxillary first rib resection likely due to anomalous chyle anatomy.

  • medical management
  • nutritional support
  • interventional radiology
  • surgery
  • vascular surgery

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  • Contributors SB: performed background literature review, reviewed case for details and wrote manuscript. MF amd GRN: provided guidance and reviewed manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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