[Tension chylothorax following left-sided lung surgery]

This is a report on 3 patients who presented with chylothoraces (chylopleurae) with haemodynamic effect subsequent to left-side lung surgery. This complication occurred twice after pneumonectomy and once after atypical resection with extirpation of a mediastinal lymph node. Clinical signs and symptoms appeared with all the patients between the 5th and 8th postoperative day, as a result of the haemodynamic effect of the chylothorax in the sense of volume loss combined with heart tamponade. In one patient there was additionally the pattern of signs and symptoms of an acute abdomen, which could be explained by a descended diaphragm with compression of the abdominal organs in case of an additionally present phrenicoparesis. One patient was at first treated conservatively after application of thoracic drainage, feeding being exclusively parenteral, and was finally operated on after 10 days, whereas the other two patients were primarily subjected to surgery. The surgical methods employed consisted of right side ductal ligature after Lampson, ductal ligature from the left thoracic side and direct closure of the chyle leakage.