治療に難渋した特発性両側乳び胸

Idiopathic Bilateral Chylothorax which Presented Difficulty in Treatment

乳び胸はなんらかの原因で胸管が破綻し，乳びが漏出して胸腔内に乳び胸水として貯留する疾患である1）．胸部外科手術では，後縦隔の手術操作時の胸管損傷による医原性乳び胸2～4）や，リンパ脈管筋腫症（LAM）や悪性リンパ腫に併発する乳び胸6，7）を経験することは珍しくないが，原因不明の特発性乳び胸を経験することは非常にまれである．われわれは治療に難渋した特発性両側乳び胸の1例を経験したので，文献的考察を加えて報告する．

A 57-year-old woman was referred to our hospital because of bilateral chylothorax. She was previously treated with dietary restriction and pleurodesis resulting in failure. She did not have diseases causing chylothorax, and was diagnosed as having idiopathic chylothorax. To control chylothorax, 2 surgical operations to ligate bilateral thoracic ducts, right pleurodesis, and 2 times of left pleurodeses was necessary.