DOI: 10.36347/sjmc8r.2018.v06i07.014

Pages: 486-489

A crucial role is played by the thoracic duct in the human body in the lymphatic system. Majority of the duct lies in the right hemithorax and can get damaged in cases of trauma or after major surgeries of the thorax. An X-ray would reveal effusion, however, the content of the effusion can only be confirmed after thoracentesis and further lab investigation. Chylothorax is the term given if the aspirate has a high triglyceride level. The nature and appearance of the aspirate cannot rule out its diagnosis as a majority of the time a milky white appearance may not be present. We report a case of 84-year-old man who underwent right lower lobar lobectomy after being diagnosed with adenocarcinoma. Postoperative symptoms were that of pleural effusion. Thoracocentesis revealed a serosanguinous fluid. He was diagnosed as having parapneumonic effusion and was started on a course of antibiotic. Not much thought and investigatory effort were put to look into chylothorax as it was low on the differential. A month later he presented with similar features and thoracocentesis revealed a milky white effusion, Labs were then done to check triglyceride which came out high suggesting chylothorax. Chylothorax in most cases will be a delayed finding, presenting approximately 10 days after surgery. Thus we want to apply the importance of mandatory investigations to check for chylothorax in all cases of effusion as it has high mortality and on the contrary, has effective and simple treatment options.