[Chylothorax. An infrequent complication in surgical exeresis of the esophagus]

Abstract

We report a case of massive bilateral chylothorax occurring after surgical resection of the esophagus in a patient with esophageal neoplasm. The surgical approach consisted of a thoracotomy and a cervicostomy. The relevance of this case is based on the low incidence of chylothorax after esophageal surgery. The literature indicates an incidence of about 0.9 to 3%. In our series of 200 patients operated on during the last 10 years we found and incidence of 2%. The patient herein reported presented an immediate postoperative clinical picture of respiratory insufficiency associated with the presence of milky fluid in the pleural drainage. Hematologic and biochemical examination of the pleural fluid confirmed the diagnosis of chylothorax. During the first 24 hours we collected a total volume of 2,500 ml of chyle. The patient was treated with conservative procedures including parenteral nutrition and intravenous reposition of fluids. After 48 hours the total volume of chyle reached 8,500 ml and the patient died.