• Abhinav Agrawal, Udit Chaddha, Viren Kaul, Ajinkya Desai, Erin Gillaspie, and Fabien Maldonado.
• Interventional Pulmonology, Division of Pulmonary, Critical Care & Sleep Medicine, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY. Electronic address: Aagrawal1@northwell.edu.
• Chest. 2022 Dec 1; 162 (6): 140214121402-1412.

AbstractChylothorax, the accumulation of chyle in the pleural space, is usually caused by the disruption of the thoracic duct or its tributaries. Etiologies are broadly divided into traumatic, including postsurgical, and nontraumatic, most commonly in the setting of malignancy. The management of chylothorax largely depends on the cause and includes dietary modification and drainage of the pleural space. A definitive intervention, whether surgical or a percutaneous lymphatic intervention, should be considered in patients with a persistently high volume of chylous output and in those with a prolonged leak, before complications such as malnutrition ensue. No methodologically robust clinical trials guiding management are currently available. In this article, we review the current literature and propose a stepwise, evidence-based multidisciplinary approach to the management of patients with both traumatic and nontraumatic chylothorax.Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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