Editing Chylothorax (section)

== '''Pathophysiology''' ==

* Extravasation from the thoracic duct
* Chyle
** A milky white fluid with a high concentration of triglycerides and chylomicrons and white blood cells
** Majority from dietary fat absorption, most of which is in the form of long chain fatty triglycerides
** Short and medium chain triglycerides are mostly absorbed through portal venous system and hence don't affect thoracic duct flow as much
** Chylomicrons travel through the lymphatic system over the course of several hours after a meal, and are then deposited into the venous system
** Nutritionally rich, depending on the nutritional and dietary status of the patient
** Can be clear
* Causes loss of fat and protein which often causes nutritional problems
** Malnutrition - loss of energy, fat, and fat-soluble vitamins, and immunoglobulin and immune cells
** Immune compromise (increased risk of bacterial infection)
** Impaired wound healing
* Volume of leak typically 0.5-3L per day
** Increased by peristalsis and even water intake
** However chyle output mainly comes from long chain triglycerides
* Chyle does not contain fibrinogen, so even small injuries to the duct will not heal