[The spontaneous, non-traumatic chylothorax. Therapy by means of pleurectomy and decortication]

Two cases of chronic spontaneus chylothorax were successfully treated by small thoracotomy with parietal pleurectomy or decortication after unsuccessful needle aspiration and intercostal tube drainage with suction. In the one case the chylous effusion occurred spontaneously 29 years after extrapleural pneumothorax. The tuberculosis was long cured. In the other, apparently idiopathic case, the chylothorax on the left side disappeared completely after pleurectomy. Six months later a chylous effusion appeared on the right side. Mediastinoscopy then revealed an oatcell carcinoma in lymph nodes without a primary pulmonary tumor. One year after radiotherapy the patient died in heart failure. No primary tumor was found. Residual chylothorax was present only on the right side.