Estudio primario
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Chylothorax, the accumulation of fatty fluid within the chest cavity, is associated with multiple etiologies including surgical injuries. A rare complication of acupuncture in a 37-year-old woman who developed left pneumothorax and pleural fluid collection after acupuncture was performed on the neck and upper back is described. Chest tube drainage resulted in complete lung expansion, and analysis of the milky fluid revealed chyle leakage. Conservative treatment with a diet low in lipids and rich in medium-chain triacylglycerols allowed extubation. Acupuncture-induced thoracic duct injury, although extremely rare, should be considered as a cause of chylothorax.
Revisión sistemática
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Revisión sistemática
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Revisión sistemática
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Resumen estructurado de revisiones sistemáticas
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Revisión sistemática
/ Estudio primario
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Revisión sistemática
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A systematic review of English and non-English articles using OVID MEDLINE (1980-2014) was performed to evaluate the potential value of prophylactic ligation of the thoracic duct in preventing chylous leakage after oesophagectomy for cancer. Search terms included [Oesophagectomy OR esophagectomy] AND [chylothorax] AND [thoracic duct ligation]. Only those papers that directly compared the incidence of chylothorax in patients who underwent prophylactic ligation [ligation group (LG)] with that in those who had conservative treatment were selected [preservation group (PG)]; all the articles presenting original data and supplying sufficient information on the chylothorax rate after oesophagectomy were included. Independent extraction of articles was performed by two authors using predefined data fields, including study quality indicators. The PRISMA guidelines were carefully adhered to. A total of 5254 subjects were included in the 7 clinical studies examined into the current meta-analysis. Of these, 2179 patients underwent prophylactic ligature of the thoracic duct (LG group) and 3075 had preservation of the thoracic duct (PG group). A significant difference in terms of chylothorax rate [odd ratios (ORs) 0.47 in favour of LG, 95% confidence interval (CI) 0.27-0.80] was noted between the LG group and the PG group. According to our meta-analysis and taking into account-specific caveats, prophylactic ligation of the thoracic duct could be considered as an effective preventative measure to reduce the incidence of postoperative chylothorax.
Estudio primario
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We present a case of tuberculosis (TB) paradoxical immune reconstitution inflammatory syndrome (IRIS) complicated by chylous ascites and chylothorax in a HIV-infected child. There are few descriptions of TB IRIS in children. This case extends the clinical spectrum of TB IRIS.
Revisión sistemática
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Revisión sistemática
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