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Right chylothorax following right internal jugular vein cannulation
Ghamdan Alsadeh1, Safwat Hamad1, Sheema Thomas Parakkal1
1Intensive Care Unit, Ibrahim Bin Hamad Obaidullah Hospital, Ras Al-Khaimah, UAE.
BMJ Case Reports
|June 26, 2026
Summary
Iatrogenic chylothorax, a rare complication of central venous catheter placement, can occur even with right internal jugular vein cannulation. This case highlights a patient who developed right-sided chylothorax, successfully treated with drainage and catheter removal.
Area of Science:
- Medicine
- Cardiology
- Thoracic Surgery
Background:
- Iatrogenic chylothorax is a rare complication following central venous catheter (CVC) insertion.
- It is typically associated with left internal jugular vein cannulation due to thoracic duct anatomy.
- Right internal jugular vein cannulation is less commonly implicated but can also lead to chylothorax.
Purpose of the Study:
- To report a case of right-sided iatrogenic chylothorax after right internal jugular vein cannulation.
- To emphasize that right IJV cannulation can cause chylothorax.
- To illustrate the diagnostic findings and successful management.
Main Methods:
- Case presentation of a patient who developed right-sided chylothorax post-right IJV cannulation.
- Analysis of pleural fluid to confirm chylothorax.
- Treatment involving pigtail catheter drainage and CVC removal.
Main Results:
- A right-sided chylothorax was diagnosed in a male patient in his early 50s after right IJV cannulation.
- Pleural fluid analysis revealed high triglyceride levels (271 mg/dL), confirming chylothorax.
- The patient showed rapid improvement following pleural fluid drainage and CVC removal.
Conclusions:
- Right internal jugular vein cannulation can lead to iatrogenic chylothorax.
- Prompt diagnosis via pleural fluid analysis and timely intervention are crucial for management.
- Conservative management with drainage and catheter removal can be effective.
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