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Updated: Mar 29, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
A Large Pleural Effusion following Abdominal Aortic Surgery
Vinoo K Ramsaran1, Vandana K Seeram1, James Cury1
1Division of Pulmonary and Critical Care Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
A rare complication of retroperitoneal surgery, chylous ascites and chylothorax, occurred in a patient five months post-aortobifemoral bypass. Treatment involved chest tube placement and chemical pleurodesis after conservative measures failed.
Area of Science:
- Medicine
- Surgery
- Pulmonology
Background:
- Chylous ascites and chylothorax are rare but serious complications after retroperitoneal abdominal surgery.
- These conditions can manifest months after an initially uncomplicated procedure.
Purpose of the Study:
- To report a case of a patient who developed chylous ascites and chylothorax post-aortobifemoral bypass.
- To review the pathophysiology and treatment of this rare complication.
Main Methods:
- A 70-year-old male patient presented with symptoms five months after aortobifemoral bypass.
- Diagnostic imaging (CT scan) confirmed ascites and pleural effusion.
- Fluid analysis confirmed chylous nature.
- Treatment included chest tube placement and chemical pleurodesis.
Main Results:
- The patient developed significant ascites and right-sided pleural effusion.
- Thoracentesis and paracentesis revealed milky fluid consistent with chylous effusion.
- Initial conservative management was unsuccessful.
Conclusions:
- Chylous ascites and chylothorax can be delayed complications of retroperitoneal surgery.
- A multidisciplinary approach involving thoracic and general surgery may be necessary.
- Management requires prompt diagnosis and intervention, including drainage and pleurodesis.
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