Simultaneous chylothorax and chylous ascites

암죽가슴증 및 암죽복수의 동시발생

  • Jang, Tae Soo (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Jeong, In Beom (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Cho, Do Yeun (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Kang, Sung Ju (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Kwon, Oh Jung (Department of Internal Medicine, Konyang University College of Medicine)
  • 장태수 (건양대학교 의과대학 내과학교실) ;
  • 정인범 (건양대학교 의과대학 내과학교실) ;
  • 조도연 (건양대학교 의과대학 내과학교실) ;
  • 강성주 (건양대학교 의과대학 내과학교실) ;
  • 권오정 (건양대학교 의과대학 내과학교실)
  • Received : 2016.07.04
  • Accepted : 2016.09.20
  • Published : 2017.12.31


Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.



  1. Brescia MA. Chylothorax: report of case in infant. Arch Pediat 1941;58:345-56.
  2. Light RW. Pleural diseases. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 327-38.
  3. Aalami OO, Allen DB, Organ CH Jr. Chylous ascites: a collective review. Surgery 2000;128:761-78.
  4. Nix JT, Albert M, Dugas JE, Wendt DL. Chylothorax and chylous ascites; a study of 302 selected cases. Am J Gastroenterol 1957;28:40-53.
  5. Lee CK, Han JM, Lee KN, Lee EY, Shin JH, Cho YS, et al. Concurrent occurrence of chylothorax, chylous ascites, and protein-losing enteropathy in systemic lupus erythematosus. J Rheumatol 2002;29:1330-3.
  6. Lee TH, Lee EY, Cho YS, Yoo B, Moon HB, Lee CK. Concurrent occurrence of chylothorax and chylous ascites in a patient with Henoch-Schonlein purpura. Scand J Rheumatol 2003;32:378-9.
  7. Villena V, de Pablo A, Martin-Escribano P. Chylothorax and chylous ascites due to heart failure. Eur Respir J 1995;8:1235-6.
  8. Cakir E, Gocmen B, Uyan ZS, Oktem S, Kiyan G, Karakoc F, et al. An unusual case of chylothorax complicating childhood tuberculosis. Pediatr Pulmonol 2008;43:611-4.
  9. Yunis EJ, Moran TJ. Chylothorax and portal cirrhosis. JAMA 1965;192:250-1.
  10. Ryu JH, Tomassetti S, Maldonado F. Update on uncommon pleural effusions. Respirology 2011;16:238-43.
  11. Nair SK, Petko M, Hayward MP. Aetiology and management of chylothorax in adults. Eur J Cardiothorac Surg 2007;32:362-9.
  12. Bhardwaj H, Bhardwaj B, Awab A. Transudative chylothorax in a patient with liver cirrhosis: a rare association. Heart Lung 2015;44:363-5.
  13. Staats BA, Ellefson RD, Budahn LL, Dines DE, Prakash UB, Offord K. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc 1980;55:700-4.
  14. Lieberman FL, Peters RL. Cirrhotic hydrothorax. Further evidence that an acquired diaphragmatic defect is at fault. Arch Intern Med 1970;125:114-7.
  15. Romero S, Martin C, Hernandez L, Verdu J, Trigo C, Perez-Mateo M, et al. Chylothorax in cirrhosis of the liver: analysis of its frequency and clinical characteristics. Chest 1998;114:154-9.
  16. McGrath EE, Blades Z, Anderson PB. Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med 2010;104:1-8.
  17. Al-Zubairy SA, Al-Jazairi AS. Octreotide as a therapeutic option for management of chylothorax. Ann Pharmacother 2003;37:679-82.
  18. Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am J Surg 1992;164:532-4.
  19. Dugue L, Sauvanet A, Farges O, Goharin A, Le Mee J, Belghiti J. Output of chyle as an indicator of treatment for chylothorax complicating oesophagectomy. Br J Surg 1998;85:1147-9.
  20. Selle JG, Snyder WH 3rd, Schreiber JT. Chylothorax: indications for surgery. Ann Surg 1973;177:245-9.