Cortés-Télles A, Rojas-Serrano J, Torre-Bouscoulet L

Language: Spanish
References: 14
Page: 157-162
PDF size: 206.85 Kb.

ABSTRACT

Introduction: Chylothorax is the presence of lymphatic fluid in the pleural space. Mexico’s National Institute of Respiratory Diseases (Instituto Nacional de Enfermedades Respiratorias) is a national level reference center; however, the frequency, causes and clinical evolution of patients with chylothorax are currently unknown.
Material and methods: Retrospective chart review of patients with chylothorax admitted to the hospital between January 1999 and December 2009.
Results: A total of 15 files were identified (47% women). Mean age was 33 years (iqr 20-67), and the average length of hospital stay was 27 days (iqr 26-38). The frequency of occurrence was 0.03% out of the 49,068 patients admitted during that period. Of the samples analyzed, 53.3% had a milky aspect, while 26% were transudates. The most frequent cause of chylothorax was non-traumatic (60%) and, of those cases, neoplasias were the most common (67%). Treatment included ligature of the thoracic conduct, total parenteral nutrition and pleurodesis. The rate of in-hospital mortality was 13.3% and was associated with sepsis.
Conclusions: The frequency of chylothorax at our center is low, as we identified only one patient with chylothorax for every 3.3 thousand hospital admissions. The non-routine measuring of triglycerides, added to the limited availability of testing for chylomicrons, suggest that chylothorax is underdiagnosed. In our series, both the causes of chylothorax and the treatment modalities are similar to those described in other studies; however, in-hospital mortality is high and related to sepsis.

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