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KMID : 0359920090280020157
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Korean Journal of Nephrology
2009 Volume.28 No. 2 p.157 ~ p.160
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A Case of Chylothorax Associated with Idiopathic Stenosis of Left Subclavian Vein in a Patient Undergoing Maintenance Hemodialysis
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Lee Yu-Min
Kim Hyun-Jung
Cha Jung-Min
Jung Duk-Eun
Lee Jae-Hun
Lee Ji-Eun
Ahn Seon-Ho
Song Ju-Hung
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Abstract
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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.
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KEYWORD
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Chylothorax, Hemodialysis, Subclavian vein
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