Chylothorax — RACP Paediatrics MCQ

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HardRespiratoryChylothoraxRACP Paediatrics

A 2-year-old post cardiac surgery develops a milky pleural effusion. Pleural fluid analysis shows triglycerides >1.1 mmol/L and chylomicrons present. What is the diagnosis?

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Correct answer: A — Chylothorax

Chylothorax is the accumulation of lymphatic fluid (chyle) in the pleural space, most commonly iatrogenic after cardiac/thoracic surgery. Fluid is milky with elevated triglycerides (>1.1 mmol/L) and chylomicrons. Management includes chest drainage, nil by mouth or medium-chain triglyceride (MCT) diet, octreotide, and surgical ligation if conservative measures fail.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Chylothorax