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A transudative chylothorax associated with superior vena cava syndrome
Adam Austin1, Faris Al-Faris2, Aakash Modi3
1Department of Medicine, Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY, USA.
Respiratory Medicine Case Reports
|July 25, 2019
Summary
This study reports a rare case of transudative chylothorax caused by Superior Vena Cava (SVC) syndrome due to catheter-related thrombosis. Endovascular intervention successfully resolved the chylothorax, highlighting the importance of treating the underlying SVC obstruction.
Area of Science:
- Cardiology
- Pulmonology
- Vascular Surgery
Background:
- Chylothorax typically presents as exudative pleural effusions.
- Transudative chylothorax associated with Superior Vena Cava (SVC) syndrome is exceptionally rare.
- Catheter-related thrombosis is a potential cause of SVC syndrome.
Observation:
- A case of transudative chylothorax secondary to SVC obstruction from a peripherally inserted central venous catheter thrombosis is presented.
- Literature review identified only five previous cases of transudative chylothorax linked to SVC syndrome.
- Thrombosis and central venous catheter complications were noted in 60% of identified SVC syndrome-associated chylothorax cases.
Findings:
- Endovascular intervention led to the successful resolution of the transudative chylothorax.
- Treatment of the underlying SVC obstruction is crucial for chylothorax resolution.
- Thoracentesis serves as an initial diagnostic and therapeutic step.
Implications:
- This case underscores the importance of considering catheter-related complications in SVC syndrome presenting with transudative chylothorax.
- Endovascular treatment is a primary modality for SVC thrombosis, with stenting favored for malignant etiologies.
- Management strategies for recurrent chylothorax include dietary modifications, medications like octreotide, and potentially surgical ligation of the thoracic duct.
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