Chylothorax after abdominal surgery

Chylothorax is usually a complication of thoracic surgery procedures. Over a 5-year period we encountered three cases of chylothorax following abdominal surgery performed in general surgery units. The initial effusions, not lactescent, were ascribed to a pleural reaction that sometimes is observed during the postoperative period after abdominal surgery. Once the diagnosis was established, the initial conservative treatment failed, and surgery was necessary. In our patients, their debilitated physical condition precluded a thoracotomy approach. A video-assisted thoracoscopy procedure was undertaken, but the extensive pleural effusions, caused in part by the delay in the diagnosis, prevented the exact localization of the duct and its closure. Talc pleurodesis was successfully employed in all patients. Even after abdominal surgery, a persistent pleural effusion should always induce us to suspect a chylothorax.