ATYPICAL PLEURAL EFFUSION SECONDARY TO TRANSDIAPHRAGMATIC COMMUNICATION - REPORT OF 2 CASES - CHYLOTHORAX AND HYDROTHORAX

We report two cases of pleural effusion in which a subdiaphragmatic ca use was noted. In both cases it was necessary to obliterate a defect i n the diaphragm via a thoracic incision. In one case, a left chylothor ax occurred in a patient with hepatic cirrhosis. In this case, it was postulated that the normal lymphatic pathway through the right hemidia phragm could have been stopped by pleural sequelae from right lobectom y. In the other case, a right pleural effusion occurred after peritone al dialysis. It is a well known pathological entity : the structural d efect can be observed by separation of collagen bundles in the tendino us diaphragm. This type of pleuro-peritoneal communication is well kno wn in women suffering from menstrual pneumothorax or in patients treat ed by peritoneal dialysis.