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Case report reveals bilateral chylothorax mimicking heart failure after left radical neck dissection, highlighting the need for prompt pleural fluid analysis and conservative nutrition therapy.
Bilateral chylothorax is a rare complication after left radical neck dissection (RND). In our patient, we encountered a chylous leak during RND and closed it by ligation and fibrin paste. Two days after RND, the patient complained of palpitation, chest pain, and shortness of breath. A chest X-ray film revealed large bilateral pleural effusions. Because the patient had a history of myocardial ischemia, a cardiologist diagnosed left heart failure. However, thoracocentesis showed a large amount of chyle in the pleural cavity. Chylothorax was diagnosed. Removal of the chyle and total parenteral nutrition rapidly improved the condition of the patient. On the 20th postoperative day, the pleural effusions disappeared.
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Ikebe et al. (1999) studied this question.
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