Chylothorax after spinal fusion surgery: A case report and literature review

Publication date: Available online 5 February 2019Source: Respiratory Medicine Case ReportsAuthor(s): Kazutoshi Toriyama, Nariaki Kokuho, Chika Yajima, Junichiro Kawagoe, Yuuki Togashi, Takao Tsuji, Hideaki Nakayama, Shinji AbeAbstractChylothorax is reported as a postoperative complication, mainly in the field of thoracic surgery, but there are only 14 reports in the field of spinal surgery.A 64-year-old woman underwent spinal fusion surgery by the anterior and posterior approach for her scoliosis. She developed leg edema and right pleural effusion 2 months after the surgery. Laboratory findings showed decreased total protein and albumin levels in serum. The color of the thoracentesis sample was pinkish white, and the Triglyceride level in the pleural effusion was high. So, her leg edema was found to be associated with malnutrition and the pleural effusion was caused by chylothorax. The point of leakage from the lymph duct was confirmed in the right thoracic cavity of the slice that corresponded to that with the screw at Th11 by lymphatic scintigraphy. Her symptoms did not improve by diet restriction and lipidol lymphography, but her pleural effusion and albumin levels improved by the administration of octreotide. In the clinical course, serum albumin levels appeared to show an inverse correlation with the amount of pleural effusion, so it was thought that her serum albumin level decreased owing to leakage of protein, including albumin, into the thoracic cavity via the injure...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research