Tunneled Pleural Catheters in the Management of Chylothorax from Central Venous Catheter-Related Superior Vena Cava Obstruction

Chylothorax is characterized by the accumulation of chyle in the pleural space, of which the most common cause is trauma or neoplasm. Although chylothorax accounts for a small proportion of clinical pleural effusions, prompt recognition is needed to avoid malnutrition, immunodeficiency, and fibrothorax. We report 2 patients with superior vena cava obstruction caused by tunneled venous catheters resulting in chylothorax and demonstrate the potential safety of tunneled pleural catheters for prolonged chylothorax drainage in an outpatient setting with rigorous follow-up. Changes in pleural fluid chemistries of the effusions and the possible pathophysiology were assessed with a review of the literature on pleural fluid chemistries in superior vena cava obstruction.