Chylothorax

Chylothorax is defined as an accumulation of chyle in the pleural space cau sed by disruption of the thoracic duct or one of its major divisions. Chyle has a high content of triglycerides. The odourless fluid is turbid and mil ky due to the presence of fat containing particles, the chylomicrons. The e tiology of chylothorax can be divided into four major categories: tumor, tr auma, idiopathic and miscellaneous. Although chylothorax is uncommon, it is a serious and potentially hazardous disorder. Loss of chyle leads to metab olic disturbances, malnutrition and immunodeficiency. Treatment consists of treatment of the underlying disease, conservative treatment (medium chain triglyceride diet, parenteral nutrition) or surgical intervention. Appropri ate timing of surgical intervention is essential. Since the ligation of the thoracic duct can be performed during thoracoscopy, this minimal intervent ional technique is the procedure of choice when conservative treatment fail s. (C) 2000 Elsevier Science B.V. All rights reserved.