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Updated: Jul 2, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Chylothorax: a rare complication of tube thoracostomy
Atikun Limsukon1, Dennis Yick, Nader Kamangar
1Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA. atikhun@hotmail.com
Background:
Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported.
Objective:
The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy.
Case Report:
An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet.
Conclusion:
The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube.
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