Post-operative chylothorax — SCE Respiratory MCQ

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ModeratePleural DiseasePost-operative chylothoraxSCE Respiratory

A 67-year-old man has milky pleural fluid after oesophagectomy. Pleural triglycerides are 2.9 mmol/L and cholesterol is low. He is clinically stable after drainage. What is the most likely diagnosis?

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Correct answer: C — Chylothorax

Milky pleural fluid with high triglycerides after thoracic surgery indicates chylothorax from thoracic duct injury. Pseudochylothorax usually has high cholesterol and occurs in chronic inflammatory effusions. Empyema, haemothorax and urinothorax have different biochemical and clinical profiles.

Reference: BTS Pleural Disease Guideline 2023