Chylous leak

Background

• Most commonly caused by lymphoma (60%)
  • Other causes
    • Trauma (25%)
    • Iatrogenic injury after head and neck surgery (15%)
      • Thoracic duct enters the neck to the left of the esophagus and arches several centimeters above the clavicle.

Clinical Features

• Chyle can accumulate in the thoracic and abdominal cavities leading to:
  • Chyle Fistula
  • Chylous Effusion
  • Chylous ascites
  • Chylothorax
  • Chylopericardium
• Leakage of fluid can lead to
  • Inflammatory reaction
  • Infection
  • Electrolyte abnormalities
  • Poor wound healing
  • Fistula formation

Differential Diagnosis

• Abscess
• Malignancy

References

Pascual J, Hsiao T, Goldstein S. Chylous Leak - The abscess doppleganger. Visual Journal of Emergency Medicine. 9C (2017) pp. 63-64