Chylothorax: A review of management options

Abstract

Chylothorax is a rare condition caused by obstruction or injury to the thoracic duct leading to accumulation of chyle in the pleural cavity. A definitive guideline for management is lacking and most cases are managed with a staged care plan that moves from the least invasive options to more invasive interventions. First-line therapy consists of treatment of underlying conditions, pleural drainage to control symptoms, and dietary modifications. Surgical measures including pleurodesis and thoracic duct ligation are pursued if conservative measures are ineffective. In recent times, percutaneous image-guided interventions such as thoracic duct embolization and thoracic duct disruption are increasingly being used. These interventions have shown promising results and are used to manage patients with failed conservative therapy, high-output chylothorax, and those who cannot tolerate surgical procedures.