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. 2015:2015:254010.
doi: 10.1155/2015/254010. Epub 2015 Nov 9.

A Large Pleural Effusion following Abdominal Aortic Surgery

Vinoo K Ramsaran  1 , Vandana K Seeram  1 , James Cury  1 , Adil Shujaat  1
Affiliations

A Large Pleural Effusion following Abdominal Aortic Surgery

Vinoo K Ramsaran et al. Case Rep Pulmonol. 2015.

Abstract

Chylous ascites and coexistent chylothorax is a rare but important complication following retroperitoneal abdominal surgery. We report a 70-year-old male who developed gradual abdominal distension, chest tightness, and dyspnea five months after having an uncomplicated aortobifemoral bypass performed. Physical examination was consistent with a large right sided effusion and ascites which were confirmed by computed tomography. Thoracentesis yielded an opaque milky fluid with analysis consistent with a chylothorax with a paracentesis revealing fluid that was similar in both appearance and biochemistry. The patient failed initial conservative management so a chest tube was placed followed by chemical pleurodesis. We review the literature of the pathophysiology and treatment approach to such a pleural effusion.

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Figures

Figure 1
Figure 1
CT scan of the chest with intravenous contrast (coronal view) showing large right sided pleural effusion with lower lobe atelectasis and perihepatic ascites.
Figure 2
Figure 2
Pleural fluid obtained on thoracentesis.
Figure 3
Figure 3
CT scan of the chest without intravenous contrast (coronal view) showing complete resolution of the right sided pleural effusion.
See this image and copyright information in PMC

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