# Navigating idiopathic Chylothorax: a case report and review of the diagnosis and management

## TL;DR

A 31-year-old man with idiopathic chylothorax required surgery after conservative treatments failed to resolve his symptoms.

## Contribution

This case highlights the diagnostic and management challenges of idiopathic chylothorax and the need for comprehensive approaches.

## Key findings

- Conservative management failed to resolve chylous drainage exceeding 1 L/day and weight loss.
- Lymphangiography did not identify a point of leakage, necessitating invasive duct ligation and decortication.
- The case emphasizes the complexity of diagnosing and treating idiopathic chylothorax.

## Abstract

We present a case of a 31-year-old male patient with Idiopathic chylothorax and concomitant pneumothorax. He presented with new-onset chest discomfort, shortness of breath, and dry cough. After establishing the diagnosis and following attempted conservative management, the patient experienced chylous drainage exceeding 1 L/day and substantial weight loss. Extensive pleural fluid and serum analysis failed to identify the underlying cause, and lymphangiography revealed no point of leakage. The patient ultimately required invasive duct ligation through thoracotomy and subsequent decortication for resolution of symptoms. This case underscores the challenges of diagnosing and managing idiopathic chylothorax and highlights the need for comprehensive approaches to such cases.