Page 1 of 1: radiology - chest

decembermist · Credits: 41121 My Scrapbook

commonest cause of chylothorax

a) trauma
b) filariasis
c) neoplasm
d) idiopathic

SATVIK · Credits: 958 My Scrapbook

Accumulation of chyle with in the pleural space(chylothorax) is most often due to surgical procedures, particularly cardiothoracic and esophageal operations.other causes include trauma,malignancy,central venous catheterisation, congenital lymphatic malformations, thoracic aortic aneurysms, filariasis and cirrhosis.
the answer here should be trauma

ref - CSDT - 2003 , pg no - 367

kannan · Credits: 6918 My Scrapbook

Yes u r right ,the commonest cause of chylothorax is trauma[confirmed from Harrison.]followed by malignancy

treatment of choice -pleuroperitoneal shunt

drpsg · Credits: 6198 My Scrapbook

AGREE WITH KANAN

IT IS TRAUMA

decembermist · Credits: 41121 My Scrapbook

ans given is neoplasm....if Harrison says its trauma...i'll go for it.

anybody got Sutton..the ref of ans is given as
sutton pg no:514

sumer sethi · Credits: 78845 My Scrapbook My Reading List 262569 Books

answer is trauma...

reference harrisons..

Chylothorax A chylothorax occurs when the thoracic duct is disrupted and chyle accumulates in the pleural space. The most common cause of chylothorax is trauma, but it also may result from tumors in the mediastinum. Patients with chylothorax present with dyspnea, and a large pleural effusion is present on the chest radiograph. Thoracentesis reveals milky fluid, and biochemical analysis reveals a triglyceride level that exceeds 110 mg/dL. Patients with chylothorax and no obvious trauma should have a lymphangiogram and a mediastinal computed tomographic (CT) scan to assess the mediastinum for lymph nodes. The treatment of choice for most chylothoraces is implantation of a pleuroperitoneal shunt. Patients with chylothoraces should not undergo prolonged tube thoracostomy with chest tube drainage because this will lead to malnutrition and immunologic incompetence.

author review of radiology

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SATVIK · Credits: 958 My Scrapbook

Even pg no 514 in Suttons says chylothorax is seen after cardiac surgery.(so trauma should be the answer)

sumer sethi · Credits: 78845 My Scrapbook My Reading List 262569 Books

so we all agree with trauma question closed!!!

Radiologist
author- review of radiology and AIIMS may2004 and nov2004

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