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Is bilateral chylothorax possible after simple cough? Yes

Fatih Candas1, Akin Yildizhan2, Rauf Gorur2

  • 1Department of Thoracic Surgery, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey fhcandas@yahoo.com.

Asian Cardiovascular & Thoracic Annals
|June 15, 2014
PubMed

Insights

Chylothorax, the accumulation of chylous fluid in the pleural space, can occur spontaneously. This case highlights a rare instance of bilateral chylothorax following a simple cough in an adult woman.

Area of Science:

  • Medicine
  • Pulmonology
  • Thoracic Surgery

Background:

  • Chylothorax involves chylous fluid accumulation in the pleural space, often due to thoracic duct impairment.
  • Pediatric chylothorax causes differ from adults, with less frequent malignancies and higher trauma resistance in children.
  • Common causes in adults include tumoral invasion and cardiopulmonary surgery.

Observation:

  • A 65-year-old woman presented with bilateral chylothorax.
  • The condition developed suddenly after a simple cough, an unusual trigger.
  • This presentation is atypical for adult chylothorax, which typically has more apparent underlying causes.

Findings:

  • The patient's bilateral chylothorax was successfully managed with conservative treatment.
  • Treatment included a medium-chain triglyceride diet to reduce chyle production.
  • Thoracentesis was employed to drain the accumulated pleural fluid.

Implications:

  • This case suggests that spontaneous chylothorax can occur in adults without significant preceding trauma or known underlying disease.
  • Conservative management, including dietary changes and fluid drainage, can be effective for certain cases of adult chylothorax.
  • Further investigation into the mechanisms of spontaneous chylothorax, even in adults, may be warranted.

Keywords:
Chylothoraxcoughthoracic duct

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