Chylothorax — SCE Respiratory MCQ

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ModeratePleural DiseaseChylothoraxSCE Respiratory

A 64-year-old man develops a milky pleural effusion after oesophagectomy. Pleural fluid triglyceride is 2.8 mmol/L and cholesterol is low. What is the most likely underlying cause?

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Correct answer: C — Thoracic duct injury

A postoperative milky pleural effusion with high triglycerides is chylothorax, most commonly due to thoracic duct injury in this context. Heart failure causes a transudate rather than triglyceride-rich chyle. Rheumatoid pleuritis is typically very low glucose and acidic but not triglyceride-rich.

Reference: BTS Pleural Disease Guideline 2023