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Chylothorax — SCE Respiratory MCQ

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HardPleural DiseaseChylothoraxSCE Respiratory

A 58-year-old man develops a milky pleural effusion 48 hours after oesophagectomy. Pleural fluid triglyceride is 2.8 mmol/L and cholesterol is low. The effusion reaccumulates rapidly despite drainage. What is the most likely diagnosis?

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Correct answer: C — Chylothorax

Milky fluid with high triglyceride after thoracic surgery is chylothorax from thoracic duct injury. Pseudochylothorax has high cholesterol and usually follows long-standing inflammatory effusions. Empyema can be turbid but would not have this triglyceride pattern.

Reference: BTS Pleural Disease Guideline 2023