Chylothorax is caused by disruption or obstruction of the thoracic duct or its tributaries that results in leakage of chyle, which can be of traumatic or nontraumatic in origin. Traumatic Chylothorax is reported as postoperative complication, mainly post thoracic surgery with few reported cases post spinal surgery especially left chylothorax post posterior approach.Ultrasound chest play an important bedside tool for rapid diagnosis of acute dyspnea, Drainage of massive effusion and daily follow up after drainage.
We present a 71- year-old female patient underwent spinal fixation surgery, developed progressive dyspnoea post operatively. Point-Of- Care-ultrasound confirmed the presence of massive pleural effusion. Ultrasound guided drainage revealed cloudy whitish fluid with high triglyceride level confirming chylothorax. The patient was managed conservatively and intravenous octreotide. Follow up Chest ultrasound revealed decreasing effusion and chest tube removed 5 days post insertion.
This is a rare complication of a common procedure. Ultrasound chest is essential tool for diagnosis of the cause of acute dyspnoea, treatment of some causes and follow up.
Tamer Mohamed Zaalouk, Zouheir Ibrahim Bitar, Ossama Sajeh Maadarani, ALAsmar Mohammed Elshably