Bilateral Chylothorax Following Left Neck Dissection and Literature Review

BackgroundAlthough chyle leakage may occur in the neck when the thoracic duct is damaged during cervical dissection, it is extremely rare for the chylothorax alone to leak chyle into the thoracic cavity. Case presentationWe report a case of bilateral chylothorax without chyle cervical leakage after left neck dissection, wherein partial left upper jaw resection and left radical neck dissection were performed in a 46-year-old woman who was diagnosed with left upper gingival cancer. The thoracic duct was ligated and cut during surgery and, although no obvious leakage of lymph was observed, dyspnea and cough reflex during deep inhalation were observed from the 3rd postoperative day. Approximately 600 mL of yellowish-white pleural effusion was aspirated during bilateral thoracentesis, and chylothorax was diagnosed based on clinical findings and biochemical analysis results. The patient was put on a low-fat diet on the 4th postoperative day, and a total of 3 neck drains were removed 8 days after the operation. ConclusionsPleural effusion disappeared on imaging examination 16 days after thoracentesis and 5 years and 6 months have passed since the operation. At this time, there has been no evidence of tumor recurrence, metastasis, or pleural effusion.

Spontaneous bilateral chylothorax in both vena cava thrombosis; cisterna chyli ligation

Chilothorax, a rare clinical condition characterized by high triglyceride white fluid in the thoracic cavity; when the literature is examined, it is seen because of trauma, malignancy, complication of surgery, and rarely central catheter-related thromboplasty. In the treatment, diet change, nutrition, drainage with tube thoracostomy, conservative method, surgical procedure with thoracotomy are applied.In our case there was no response to nutritional changes, drainage, thoracotomy and somatostatin treatments. Cisterna chyli ligation was performed with laparotomy. We present a case of spontaneous bilateral chylothorax associated with superior and inferior vena cava thrombosis (without central catheter relationship).

Bilateral Chylothorax Following Total Thyroidectomy with Neck Dissection for Papillary Thyroid Cancer

Bilateral chylothorax is a rare entity that occurs after a thyroidectomy and neck dissection. This rare condition can lead to severe morbidity, and potentially death, if not managed properly. We report a rare complication of neck surgery and subsequent bilateral pleural effusion, regarding a 35-year-old female who presented at Sultan Qaboos University Hospital in 2018 with shortness of breath and respiratory distress. Particularly, the bilateral pleural effusion and related symptoms occurred one week after a total thyroidectomy with central and left lateral neck dissection. Intraoperative findings, management and literature review will be discussed. Keywords: chylothorax, thyroid cancer, papillary, thyroidectomy, neck dissection, Case report; Oman.