Successful treatment of bilateral idiopathic chylothorax with ligation of the thoracic duct and octreotide

DOI 3 References
  • Motoishi Makoto
    Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center
  • Okamoto Keigo
    Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center
  • Kataoka Yoko
    Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center
  • Sawai Satoru
    Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center
  • Oshio Mayumi
    Department of Thoracic Surgery, National Hospital Organization Minami-Kyoto Hospital
  • Hanaoka Jun
    Department of Thoracic Surgery, Shiga University of Medical Science

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  • 胸管結紮術およびオクトレオチド投与にて軽快した両側特発性乳糜胸の1例

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Abstract

A 51-year-old woman was admitted to our hospital with bilateral pleural effusion. She underwent thoracentesis, and was diagnosed with bilateral chylothorax. Owing to the absence of an apparent causative disease, she was diagnosed with bilateral idiopathic chylothorax. She was treated conservatively with low-fat-diet therapy and continuous chest tube drainage, but the pleural effusion again increased after three months. Then, ligation of the thoracic duct was performed. Left chylous pleural effusion increased on the evening of the day after surgery and drained at about 800 ml/day on the third postoperative day. Therefore, octreotide and low-fat-diet therapy were started. Chylous effusion decreased and the patient was discharged after the administration of octreotide for two weeks. No recurrence was observed in the follow-up after over a year. Idiopathic chylothorax is a rare disease, and optimal treatment has not yet been established. Furthermore, additional treatments are often needed after surgery because of incomplete healing. We believe that octreotide is useful for patients with idiopathic chylothorax who do not improve upon ligation of the thoracic duct.

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