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Chylothorax — SCE Respiratory MCQ

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ModeratePleural diseaseChylothoraxSCE Respiratory

A 61-year-old woman develops a large milky pleural effusion two weeks after oesophagectomy. Pleural fluid triglyceride is 2.4 mmol/L and cholesterol is not elevated. There is no fever and cultures are negative. She becomes breathless whenever drainage is clamped. What is the most likely diagnosis?

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Correct answer: D — Chylothorax

Milky pleural fluid with high triglyceride after thoracic surgery is chylothorax from thoracic duct injury. Pseudochylothorax usually has high cholesterol and occurs with long-standing effusions. Management depends on output and nutritional status, often requiring dietetic and thoracic surgical input.

Reference: BTS Pleural Disease Guideline 2023