What’s the cause of this milky white fluid?

October 24, 2018

Figure 1 Quiz of the Week

Three days after a coronary artery bypass grafting, a 55-year-old woman presents with dyspnea, fatigue, and heaviness in the chest. 200 mL of milky white fluid is drained by thoracentesis. The fluid has a triglyceride count of 120 mg/dL.

What is the most likely diagnosis?

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Image Credit: @ILoveICU.


Answer:  Chylothorax

Chylothoraces are commonly caused by a disruption or obstruction of the thoracic duct. The thoracic duct, the body’s largest lymph channel, can be damaged by an underlying condition or surgical intervention. As a result, chyle from the thoracic duct accumulates in the pleural space. Chylothoraces can be managed with pleural drainage, a modified diet, pleurodesis, or thoracic duct ligation.

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