Chylothorax, a postoperative complication of the aortocoronary bypass surgery

History and clinical findings: One month after a coronary bypass grafting o peration, pericardial- und pleural effusions were found in a 75-year-old wo man. Dressler-syndrom was assumed and an antiphlogistic and cortisone were prescribed. Under this therapy, the pericardial effusion disappeared, but t he pleural effusion increased in size. After thoracocentesis, the diagnosis of a chylothorax could be confirmed. Three days later, the thoracic radiog raphy was inconspicuous and the patient was discharged without changes in m edication. As dyspnea occurred two weeks later, the patient was admitted to our hospital. Investigations: The thoracic radiography showed a reappearance of the pleur al effusion. Diagnosis, therapy and course: The laboratory test confirmed a relapse of t he chylothorax. After a pleurodesis by drainage and a prescription of a hig h-caloric, fat-reduced diet the patient could be discharged two weeks later . The diet could be terminated two months later after a recurrence of the c hylothorax had been excluded in the thoracic radiography. In the follow-up examinations, there was no evidence for a relapse of the chylothorax. Conclusions: The chylothorax is an uncommon postoperative complication of t he aortocoronary bypass surgery. A relapse is likely and it can result in l ife-threatening cachexia. Therefore, a early and adequate therapy is import ant.