We report a case of chylo-retroperitoneum and chylothorax following an
uneventful left radical nephrectomy for renal cell carcinoma, and pro
pose the mechanism of an infradiaphragmatic lymphatic injury with fist
ulous connection into the chest. Treatment with oral medium chain trig
lycerides was unsuccessful. Subsequently, total parenteral nutrition i
n conjunction with chest drainage, retroperitoneal drainage and sclero
therapy successfully treated the chylothorax. To our knowledge chyloth
orax following radical nephrectomy has not been reported previously in
the literature.