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Transudative chylothorax and frailty: a diagnostic and therapeutic challenge
  1. Liz Robinson,
  2. Sze Ooi and
  3. Ben Prudon
  1. Respiratory Medicine, University Hospital of North Tees, Stockton-on-Tees, UK
  1. Correspondence to Dr Liz Robinson; liz.robinson12{at}


Transudative chylothoraces are a rare entity and their management in the presence of multiorgan dysfunction and frailty is complex. A woman in her 90s was investigated during acute hospital admission and found unexpectedly to have a transudative chylothorax secondary to cryptogenic cirrhosis. Not all chylothoraces have the classically described milky appearances and a high index of suspicion is vital in determining appropriate investigation and management. Our patient required repeated thoracocentesis and subsequently chose to be discharged from hospital with comfort care. Management of non-malignant pleural effusions can be challenging. Case reports surrounding the management of transudative chylothoraces in particular are scarce. Establishing patient priorities and openly explaining the uncertainty regarding prognosis and potential therapeutic options is paramount in this complex and changing field.

  • Respiratory medicine
  • Cirrhosis

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  • Contributors LR: lead author in all aspects excluding the case presentation and consent process. SO: coauthored the case presentation and was involved in consent process. BP: reviewed the article.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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