American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is a common diagnostic approach to managing chylothorax?

1. Immediate surgical exploration

2. Observation and dietary modification

3. Chemotherapy

4. External radiation therapy

The correct answer is: Observation and dietary modification

The common diagnostic approach to managing chylothorax is observation and dietary modification. Chylothorax typically arises due to the accumulation of lymphatic fluid in the pleural space, often following thoracic surgery or trauma. It's important to assess the patient's clinical stability and the volume of fluid collected. In many cases, conservative management strategies can be effective, particularly if the chylothorax is not causing significant respiratory distress or is not rapidly accumulating. Dietary modifications, such as the use of a low-fat diet or medium-chain triglycerides, can help reduce the amount of chyle production since these types of fats bypass the lymphatic system. Monitoring the patient closely allows for reassessment of the situation, ensuring that any changes in the patient's condition can be addressed promptly. If conservative measures fail and the chylothorax persists or worsens, more invasive interventions, such as surgery or drainage procedures, may be considered, but these are usually not the first line of management.