Abstract
Chylotorax is a relatively uncommon and difficult to treat complication after esophagectomy for cancer. We report a case of a young adult male who underwent neoadjuvant chemoradiationtherapy followed by Ivor-Lewis esophagectomy for a squamous-cell carcinoma of the distal esophagus. During the postoperative course the patient presented recurrent episodes of hemodynamic instability mimicking cardiac tamponade, secondary to compression of the left pulmonary vein and the left atrium by a mediastinal chylocele. Mediastinal drainage and ligation of the cisterna chyli and the thoracic duct was successfully performed through a transhiatal approach.
Highlights
Chylotorax is a rare but potentially life-threatening complication of esophagectomy [1]
We report the case of a patient with postoperative chylotorax who presented with hemodynamic instability mimicking cardiac tamponade and was treated through a transhiatal approach after an unsuccessful attempt at conservative management
A CT scan demostrated the presence of a retrocardiac fluid collection, extending from the level of the esophagogastric anastomosis to the diaphragm and causing compression of the left pulmonary vein and the left atrium (FIGURE 1)
Summary
Chylotorax is a rare but potentially life-threatening complication of esophagectomy [1]. We report the case of a patient with postoperative chylotorax who presented with hemodynamic instability mimicking cardiac tamponade and was treated through a transhiatal approach after an unsuccessful attempt at conservative management. On postoperatively day 3 a left pleural effusion was detected on the chest x-ray and about 2 liters of serous fluid were drained.
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