Hepatic Chylothorax: An Uncommon Pleural Effusion

• Published in: JIM - high impact case reports Vol. 11; p. 23247096221150634
• Main Authors: Akbar, Aelia, Hendrickson, Tara, Vangara, Avinash, Marlowe, Stanley, Hussain, Akbar, Ganti, Subramanya Shyam
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2023; Sage Publications Ltd; SAGE Publishing
• Subjects: Aged, 80 and over; Ascites; Ascitic Fluid; Case Report; Case reports; Chronic obstructive pulmonary disease; Chylothorax - etiology; Chylothorax - therapy; Humans; Liver cirrhosis; Liver Cirrhosis - complications; Male; Pleural effusion; Pleural Effusion - diagnostic imaging; Pleural Effusion - etiology; Pleural Effusion - therapy; exudative; ascites; chylothorax; transudative; hepatic hydrothorax; pleural effusion; liver cirrhosis
• ISSN: 2324-7096; 2324-7096
• DOI: 10.1177/23247096221150634

An 83-year-old male with chronic obstructive pulmonary disease and liver cirrhosis presented with confusion and dyspnea. On chest X-ray, he had the right mid to lower lung zone white out. Ultrasound-guided thoracentesis drained 1.5 L of milky white pleural fluid which was transudative according to chemical analysis. Transudative chylothorax in liver cirrhosis without ascites is rare, but can happen. When the flow of ascitic chylous fluid into the pleural space equals the rate of ascites production, clinical absence of detectable ascites will occur. Hepatic chylothorax is important and should be kept in differentials when evaluating patients with liver cirrhosis.