Refractory chylothorax following COVID-19: Successful surgical management of a rare complication; a case report
Year: 2024
Type: article
Study design: Case Report
Abstract: INTRODUCTION AND IMPORTANCE: Chylothorax is an uncommon complication linked to COVID-19. The fundamental pathophysiology and most effective management strategy are still uncertain. CASE PRESENTATION: A 72-year-old man presented with worsening dyspnea and fatigue one month post-COVID-19. Imaging demonstrated a significant right pleural effusion, with thoracentesis confirming the presence of chylothorax. Despite the implementation of conservative interventions, the effusion remained unresolved. During the right thoracotomy procedure, a 1 cm (about 0.39 in) perforation in proximity to the Azygos vein, encircled by hypertrophic lymph nodes, was identified. Surgical intervention successfully alleviated the symptoms. CLINICAL DISCUSSION: This case implies that mediastinal lymphadenopathy because of COVID-19 could potentially obstruct and interfere with the thoracic duct. This emphasizes the significance of considering chylothorax as a crucial diagnostic possibility in individuals presenting with new onset pleural effusions following COVID-19. Although conservative approaches are typically the first line of management, persistent cases may necessitate surgical intervention to target the root cause. CONCLUSIONS: Additional research is imperative to elucidate the intricate pathways connecting COVID-19 and chylothorax, as well as to ascertain the most effective diagnostic and therapeutic approaches.
Authors: Nasrin Rahmani Ju, Masoud Saadat Fakhr, Poorya Gholami, Fatemeh Khosravi, Kiana Rezvanfar
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,800
OpenAlex ID: W4403054914