Case Report: Management of idiopathic chylothorax

Chylothorax is characterized by the presence of chyle in the pleural space and results from lesion or obstruction of the thoracic duct. We present two cases of non-traumatic, idiopathic chylothorax in two females that were treated differently. The first is a 42 year old female who presented with a symptomatic right chylothorax. Treatment by a low-fat diet supplemented with medium chain triglyceride and evacuation of the pleural fluid was sufficient. The second patient is a 25 year old female admitted for a bilateral chylothorax. Despite optimal medical therapy, chylothorax continued to persist. Finally thoracic duct ligation was performed, which resulted in resolution of the effusion. These two cases illustrate that the management of idiopathic chylothorax can be surgical or nonsurgical.