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Eur J Cardiothorac Surg 2003;24:466-468
© 2003 Elsevier Science NL

Case report

Bilateral chylothorax after thymectomy via median sternotomy and resolution through conservative treatment

Thoracic Surgery Service, General Universitary Hospital, Maestro Alonso 109, 03010 Alicante, Spain

Received 10 March 2003; received in revised form 2 May 2003; accepted 12 May 2003.

^* Corresponding author. Tel.: +34-96-510-118/69-94-383-50; fax: +34-96-59-36-329
e-mail: jjmafe{at}yahoo.es

Thymectomy has been shown to be effective in the treatment of myasthenia gravis patients. Rarely, bilateral chylothorax, was noted as a complication of thymectomy via median sternotomy. Probably unseen division of mediastinal lymphatics, remote from thoracic duct, can explain this phenomenon. We report the case of a patient, female, who developed bilateral chylothorax after the former surgical approach, and our initial conservative policy to treat it (unilateral chest tube, total parenteral nutrition and subcutaneous administration of octreotide, a long-acting somatostatin analog), with good results.

Key Words: Chylothorax • Thymectomy • Myasthenia • Sternotomy • Octreotide • Drainage