Pediatric Chylothorax

  • Etiology: Traumatic tear of the thoracic duct
  • Imaging CXR: Large pleural effusion
  • DDX:
  • Complications:
  • Treatment: Fat restricted diet or total parenteral nutrition
  • Clinical:
    — Most common cause of large neonatal pleural effusion
    — Consider if there could be underlying lymphatic malformation or pulmonary lymphangiectasia

Radiology Cases of Chylothorax

Radiology Cases of Chylothorax Due to Thoracic Duct Tear at Birth

CXR of chylothorax
CXR shows a large right pleural effusion.

Radiology Cases of Chylothorax due to Cardiac Surgery

CXR of chylothorax
CXR AP shows a large right pleural effusion which when tapped had a milky appearance.

Radiology Cases of Chylothorax due to Lymphangioleiomyomatosis

CXR and CT of lymphangioleiomyomatosis
CXR PA (above left) shows large bilateral pleural effusions. Axial CT with contrast of the chest (above right) shows the pleural effusions to be septated. The lung parenchyma (middle) was normal while the bones (below) had multiple cystic bone lesions in the right scapula, vertebral bodies and bilateral ribs.