A CASE OF A HYPOPLASTIC LUNG FOUND TO BE INCIDENTALLY A CHYLOTHORAX

TOPIC: Procedures TYPE: Fellow Case Reports INTRODUCTION: Chylothorax is a well described complication after thoracic interventions. It can occur in wide variety of procedures such as brachiocephalic manipulation or lymph node dissection. Often, there be disruption the lymphatic drainage resulting chlye draining into pleural space. We discuss case where patient was found to have chylothorax intervention performed his fistula previously placed for hemodialysis access. While under fluoroscopy operating room, effusion mischaracterized hypoplastic lung which prompted pulmonary consultation. Drainage cavity, by bedside ultrasound guided thoracentesis, showed elevated triglycerides. CASE PRESENTATION: The 53-year-old physically active, non-smoking, gentleman with history end-stage renal disease secondary unknown cause, transplant rejection, and hypertension. He initially on peritoneal dialysis but converted AV creation one year ago. However, this complicated venous stenosis requiring multiple dilation procedures. also developed left neck arm swelling since insertion has not properly matured. Due worsening dyspnea, he presented repeat fistulogram. Under fluoroscopy, concern (IMAGE 1). Chest radiography post-procedure (FIGURE 2), confirmed ultrasound. Bedside thoracentesis yielded 1.5 liters milky, layering, blood tinged free flowing fluid. Pleural fluid analysis revealed 211 mg/dL During 2 week follow up visit, noted recurrent shortness breath. fluid, prompting second recovered straw-colored Repeat triglyceride level 30 DISCUSSION: Occlusion duct lead chylous extravasation accumulation. Our four times, first being chylothorax, not. His suspected superior vena cava syndrome from webbing region that required balloon angioplasty numerous fistulograms eventually tied off at request. instructed decrease dietary fatty acid intake. If conservative measures do improve condition if vascular cannot alleviate stenosis, pleurodesis will need considered prevent reaccumulation. CONCLUSIONS: ESRD patients may effusions due nephrosis, we present possible SVC provoked AVF leading obstruction caused chylothorax. Further management situation address underlying near recurrence. REFERENCE #1: Bryant, Ayesha S. et a. Incidence Management Postoperative After Pulmonary Resection Thoracic Mediastinal Lymph Node Dissection. Annals Surgery, Volume 98, Issue 1, 232 - 237. 2014. DISCLOSURES: no disclosure file Ronald Evans; No relevant relationships Salman Khan, source=Web Response Sudheer Penupolu,