DOI: 10.12890/2025_004929

A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient

Authors

  • Umberto Giuseppe Galasso Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Geriatric Unit, Sapienza University of Rome, Rome, Italy
  • Elena Del Giudice Department of Internal Medicine, Geriatric Unit, San Giovanni-Addolorata Hospital, Rome, Italy
  • Pasquale Ialongo Department of Radiology and Imaging, San Giovanni-Addolorata Hospital, Rome, Italy
  • Filippo Luca Fimognari Department of Internal Medicine, Geriatric Unit, Annunziata Hospital, Cosenza, Italy
  • Giovambattista Desideri Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Geriatric Unit, Sapienza University of Rome, Rome, Italy
  • Evaristo Ettorre Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Geriatric Unit, Sapienza University of Rome, Rome, Italy
  • Lorenzo Palleschi Department of Internal Medicine, Geriatric Unit, San Giovanni-Addolorata Hospital, Rome, Italy

galassog3@gmail.com

Keywords

Chylothorax, vertebral osteophytosis, elderly

Abstract

Background: Chylothorax is an abnormal accumulation of lymphatic fluid in the pleural cavity, and it develops because of chyle leaking from the thoracic duct. The clinical presentation can be varied, while symptoms depend on its size and the rate of accumulation in the pleural space. Diagnosis is based on pleural fluid analysis, supported by various imaging studies to help determine the underlying pathology and locate the site of chyle leak.
Case report: We report an extremely rare case of non-iatrogenic right-sided chylothorax in the absence of radiographically demonstrated bony damage which was related to vertebral osteophytosis in a 90-year-old man, who presented with worsening shortness of breath after a blunt trauma. On physical examination, the patient was found to be suffering from substantial right-sided pleural effusion with no radiographic evidence of traumatic injury.
Conclusion: Imaging demonstrated diffused osteophytosis at the level of the lower thoracic vertebrae, which were puncturing the thoracic duct. We adopted conservative treatment, including thoracentesis and total parenteral nutrition, which resulted in the improvement and resolution of symptoms.

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References

  1. Ur Rehman K, Sivakumar P. Non-traumatic chylothorax: diagnostic and therapeutic strategies. Breathe (Sheff) 2022;18:210163.
  2. Bhatnagar M, Fisher A, Ramsaroop S, Carter A, Pippard B. Chylothorax: pathophysiology, diagnosis, and management-a comprehensive review. J Thorac Dis 2024;16:1645-1661.
  3. Riley LE, Ataya A. Clinical approach and review of causes of a chylothorax. Respir Med 2019;157:7-13.
  4. Mohamed M, Alshenawy W, Kegarise C, Betten D. Bilateral Chylothorax Due to Blunt Trauma Without Radiographic Evidence of Traumatic Injury. Clin Pract Cases Emerg Med 2017;1:111-114.
  5. Apostolakis E, Akinosoglou K, Koletsis E, Dougenis D. Traumatic chylothorax following blunt thoracic trauma: two conservatively treated cases. J Card Surg 2009;24:220-222.
  6. Horiuchi K, Asakura T, Sakaguchi S, Saito F. Bilateral chylothorax associated with osteophytes in an elderly patient. BMJ Case Rep 2019;12:e229473.

Published

2025-02-19

Issue

Vol. 12 No. 3 (2025)

Categories

How to Cite

1.
Galasso UG, Del Giudice E, Ialongo P, Fimognari FL, Desideri G, Ettorre E, et al. A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient. EJCRIM [Internet]. 2025 Feb. 19 [cited 2026 Nov. 3];12(3). Available from: https://ejcrim.com/index.php/ejcrim/article/view/4929