Abstract
Idiopathic chylothorax is rare. We report a case of idiopathic chylothorax with ascites. A 59-year-old woman was admitted to a hospital for the presence of right pleural effusion on a chest radiograph. Thoracentesis revealed milky effusion with high concentration of triglyceride (1700mg/dl). An abdominal CT revealed fluid collection in Douglas' cul-de-sac. The aspiration of the ascites from Douglas' cul-de-sac yieled milky fluid. She was treated conservatively for two months but the pleural effusion did not decrease. The patient was transferred to our hospital. She underwent surgery in our hospital in September 2007. A right thoracotomy revealed nothing abnormal except for the oozing of lymph from the mediastinal pleura. Ligation of the thoracic duct was performed. After surgery, the amount of pleural effusion decreased but approximately 100 ml of effusion was drained. She underwent pleurodesis at the 10th postoperative day. After the pleurodesis, the amount of chyle gradually reduced, and we were able to remove the chest drainage tube on the 16th postoperative day. At the last follow-up, 10months after discharge, the patient remained well.
