Clinical analysis of 19 cases of liver cirrhosis complicated with chylous hydrothorax
10.3760/cma.j.cn113855-20240516-00368
- VernacularTitle:肝硬化合并乳糜性胸水19例临床分析
- Author:
Yan ZHU
1
;
Song XIA
1
;
Yuguang SUN
1
;
Jianfeng XIN
1
;
Wenbin SHEN
1
Author Information
1. 首都医科大学附属北京世纪坛医院淋巴外科，北京 100038
- Publication Type:Journal Article
- Keywords:
Cirrhosis;
Thoracic duct;
Chylous pleural effusion;
Lymphangiography
- From:
Chinese Journal of General Surgery
2025;40(5):370-374
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics, diagnosis, and treatment of chylous pleural effusion caused by liver cirrhosis.Methods:The clinical data of 19 cases of liver cirrhosis complicated with chylous pleural effusion admitted at Department of Lymphatic Surgery, Beijing Shijitan Hospital from Jun 2013 to Oct 2022 was retrospectively analyzed.Results:There were 12 males (63.2%) and 7 females (36.8%).Ten cases (52.6%) had right chylothorax, and 9 cases (47.4%) had bilateral chylothorax; Seventeen cases (89.5%) had concurrent ascites. Chest fluid examination: 3 cases were milky white (16%), 10 cases were yellow white (53%), 4 cases were orange yellow (21%), and 2 cases were pink (10%).There were 2 cases of exudate and 17 cases of transudate. By radionuclide lymphatic imaging, 9 cases showed increased radiation in the right chest cavity; One case showed increased radiation in the left chest cavity; Five cases showed bilateral chest radiation elevation. By lymphangiography,11 cases showed complete visualization of the thoracic duct, of which 10 cases showed obstruction at the outlet of the thoracic duct. The 10 patients underwent surgical treatment for the release of adhesions at the end of the thoracic duct, and the postoperative result was good. Six patients died during follow-up.Conclusions:Cirrhosis combined with chylous pleural effusion is rare in clinical practice and prognosis is poor. The laboratory examination of pleural effusion is an important basis for determining chylous pleural effusion. The lysis of adhesions at the end of the thoracic duct has a certain therapeutic effect on patients with lymphangiography indicating thoracic duct outlet obstruction.
