Postpartum chylothorax: Two case reports and literature review

Postpartum chylothorax is an infrequent complication of delivery that is sometimes overlooked. We presented 2 cases of chylothorax in primiparous women who developed chest tightness and breath shortness after vaginal birth, probably due to increased pressure in the thoracic ducts during labor. Lymphography with iodine oil revealed leakage at the T4 level of the thoracic duct in 1 patient but not in the other. Only trace amounts of iodized oil were deposited in the thoracic cavity. There was a significant decrease in postoperative drainage. However, the treatment did not yield the anticipated curative effect in either case. Eight incidences of postpartum chylothorax were identified in the reviewed literature. Patients with refractory chylothorax may benefit greatly from lymphography since it can detect structural changes and determine whether there is a leaking in the thoracic duct. Lymphography-guided therapy for chylothorax with a verified leak has the potential to be both effective and safe. Lymphangiography can serve as a useful tool in selecting the optimal surgical strategy.