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J Thorac Cardiovasc Surg 2003;126:1199-1200
© 2003 The American Association for Thoracic Surgery

Brief communication

Chylous leak after cervical mediastinoscopy

Françoise Le Pimpec Barthes, MDa, Nicola D'Attellis, MDb, Jalal Assouad, MDa, Alain Badia, MDa, Redha Souilamas, MDa, Marc Riquet, MD, PhDa,*

a Service de Chirurgie Thoracique, Hôpital Européen Georges Pompidou, Paris, France,
b Service d'Anesthésie Réanimation, Hôpital Européen Georges Pompidou, Paris, France

Received for publication August 29, 2002; accepted for publication October 22, 2002.

* Address for reprints: Marc Riquet, MD, PhD, Service de Chirurgie Thoracique, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc, 75015 Paris, France
marc.riquet@hop.egp.ap-hop-paris.fr

The first 20% of the full text of this article appears below.

Chylous leak after cervical mediastinoscopy is a rare complication.1 To our knowledge, 3 cases have been reported in the literature.2-4 Three consecutive cases observed at our institution drew our attention to its possibly underrated occurrence.

Clinical summary

PATIENT 1. A 16-year-old girl reported having weight loss and asthenia after an episode of erythema nodosum. On physical examination, there was no lymphadenopathy or hepatomegaly. The chest radiograph demonstrated bulky paratracheal lymph nodes. Tuberculosis was suspected but could not be confirmed. Diagnosis was assessed by cervical mediastinoscopy, so as to rule out a lymphoma. During the procedure, active suction drainage of the mediastinal bed was used, yielding 300 mL of a milky fluid on postoperative day 1. A chylous leak was confirmed by the presence of chylomicrons and triglycerides (14.6 mmol/L) in the fluid. Suction was discontinued, and a medium-chain triglyceride (MCT) diet was started. . . . [Full Text of this Article]






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