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Chylothorax is an uncommon cause of pleural effusion. Recurrent chylous effusions are often resistant to conservative treatment and many need surgical intervention. We report a 69-year-old woman with refractory idiopathic chylothorax resistant to medium-chain triglyceride diet and intermittent thoracentesis. Lymphangiography and lymphoscintigraphy failed to identify the site of leakage. We initiated continuous positive airway pressure (CPAP) 12 h before and 48 hours after talc pleurodesis. Chest drain was removed at day 3 and she was discharged at day 5. To our knowledge, this is the first case of successful resolution of idiopathic refractory chylothorax with CPAP ventilation used in tandem with talc pleurodesis.
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http://dx.doi.org/10.1002/rcr2.624 | DOI Listing |
Multimed Man Cardiothorac Surg
September 2025
Institute of Chest Surgery, Medanta, Gurugram, India
Birt-Hogg-Dubé syndrome (BHDS) is an autosomal dominant inherited disorder caused by mutation in a tumour suppressor gene, FLCN, leading to skin tumours (fibrofolliculomas), renal tumours and pulmonary cysts. Lung involvement is predominantly observed in 70% of the cases of BHDS, manifesting in the form of recurrent primary spontaneous pneumothorax. This video tutorial showcases the surgical management of recurrent right primary spontaneous pneumothorax in a young adult with a history of multiple episodes of bilateral pneumothorax managed by surgical intervention previously.
View Article and Find Full Text PDFRespirol Case Rep
September 2025
Respiratory Unit Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia.
Management of malignant pleural effusion (MPE) via medical thoracoscopy presents a clinical challenge, particularly when deciding whether to proceed with talc poudrage during the same setting. This decision is often complicated by uncertainty about lung re-expansion and the potential failure of pleurodesis. We describe a series of three patients with cancer-associated MPE who underwent medical thoracoscopy with talc poudrage combined with indwelling pleural catheter (IPC) insertion.
View Article and Find Full Text PDFJCI Insight
August 2025
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Inte, University of Cincinnati, Cincinnati, United States of America.
Talc pleurodesis is highly effective for preventing recurrence of pneumothorax and pleural effusion, but can be complicated by dissemination, acute lung injury, lead exposure, and foreign body-induced chronic inflammation and pain. Our objective is to develop a safe, biodegradable, contaminant-free particle for pleurodesis. We used mouse models of pneumothorax and malignant pleural effusion to compare the efficacy and safety of pleurodesis with talc and hydroxyapatite microspheres (HAM).
View Article and Find Full Text PDFCureus
July 2025
Pulmonary and Critical Care Medicine, San Juan City Hospital, San Juan, USA.
Persistent air leaks (PALs) present a significant challenge in patients with underlying structural lung abnormalities, such as emphysema. Conventional interventions, including chemical pleurodesis, may be ineffective or poorly tolerated in this population. We present a case of a high-risk patient with refractory pneumothorax successfully managed with autologous blood patch pleurodesis (ABPP).
View Article and Find Full Text PDFCureus
June 2025
Cardiology and Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, GBR.
Autologous blood patch pleurodesis (ABPP) is a novel therapeutic option for persistent/refractory pneumothorax (PTX) in patients who fail to respond to the initial thoracostomy procedure. Previous evidence from the literature suggests its successful implementation in secondary spontaneous PTX. We present our experience with autologous blood pleurodesis being used successfully in a primary spontaneous PTX.
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