Korean J Nephrol.  2009 Mar;28(2):157-160.

A Case of Chylothorax Associated with Idiopathic Stenosis of Left Subclavian Vein in a Patient Undergoing Maintenance Hemodialysis

• Lee YM
• Kim HJ
• Cha JM
• Jung DE
• Lee JH
• Lee JE
• Song JH
• Ahn SH

Abstract

Chylothorax is defined as the accumulation of chyle-containing lymphatic fluid within the pleural space. The causes of chylothorax are various and usually attributable to 1 of 4 categories: malignancy, trauma (including surgery), miscellaneous disorders, and idiopathy. Occurrence of chylothorax in patients on hemodialysis is very uncommon and it may have resulted from multiple iatrogenic vascular trauma conducive to venous thrombosis and stenosis when hemodialysis catheters required frequent changes or long term indwelling. Local thrombosis and stenosis may increase the venous hydrostatic pressure and hinder the discharge of thoracic duct lymph into the venous system. Hence, chylous lymphatic fluid leak into the pleural space. Treatment of chylothorax may range from nonoperative management to elective surgery. We report a case of a patient on hemodialysis who developed chylothorax secondary to a subclavian vein stenosis without any other symptoms such as arm edema and successfully treated with nonoperative management.

Keyword

Chylothorax; Hemodialysis; Subclavian vein

MeSH Terms

Arm
Catheters
Chylothorax
Constriction, Pathologic
Edema
Humans
Hydrostatic Pressure
Renal Dialysis
Subclavian Vein
Thoracic Duct
Thrombosis
Venous Thrombosis