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复发性双侧特发性乳糜胸:治疗挑战。

Recurrent bilateral idiopathic chylothorax: a therapeutic challenge.

机构信息

Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia

Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.

出版信息

BMJ Case Rep. 2023 Dec 16;16(12):e258049. doi: 10.1136/bcr-2023-258049.

Abstract

Chylothorax is a rare condition caused by pleural effusion resulting from thoracic duct injury. Recurrent chylothorax is often resistant to conservative treatment and presents a clinical conundrum in its management. Here, we report a compelling case of recurrent chylothorax that persisted despite the administration of total parenteral nutrition, octreotide and thoracic duct embolisation. The patient eventually required thoracic duct ligation and talc pleurodesis, which resulted in the resolution of the effusion. Our case is an illustrative example of the effective multidisciplinary management of recurrent bilateral idiopathic chylothorax.

摘要

乳糜胸是一种罕见的疾病,由胸导管损伤导致胸腔积液引起。复发性乳糜胸常对保守治疗有抵抗力,并在其管理中呈现出临床难题。在这里,我们报告了一例引人注目的复发性乳糜胸病例,尽管给予了全肠外营养、奥曲肽和胸导管栓塞治疗,但仍持续存在。患者最终需要进行胸导管结扎和滑石粉胸膜固定术,从而使胸腔积液得到解决。我们的病例是一个说明性的例子,展示了复发性双侧特发性乳糜胸的有效多学科管理。

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