Chylothorax, Symptoms, Causes, Types and Ayurvedic Treatment

Abstract

Chylothorax is a condition which is having a particular characteristic of abnormal accumulation of chyle. Chyle is a milky fluid that contains fat droplets. These are drained from the lacteals of the small intestine into the lymphatic system during digestion. When this chyle is accumulated in the space surrounding the lungs it is termed as chylothorax. It is a rare but serious condition as it signals the leak of thoracic duct or one of its tributaries. Most of the pleural effusion (collection of fluid in pleural cavity) cases have serous fluid accumulated but only two to three percent represents chyle. In this article we will be discussing the causes, signs and symptoms, types, mechanism, diagnosis and treatment of  chylothorax.

Introduction

In Chylothorax, the word chylo is derived from a Greek word chylos that means juice and in medical terms thorax represents lung area. The leakage of chyle through the thoracic duct is very common after thorax surgeries or in association with thorax tumors, after congenital cardiac surgeries and even after esophageal surgeries. For this condition there is no prediction of sex or age, it can happen to anyone weather a male or a female, children or adult. Early complications in these cases are cardiorespiratory and volemic disturbances.

Causes

There are three causes of chylothorax:

1. Traumatic causes include postoperative chylothorax
2. Non-traumatic includes cancerous formation in the thorax region.
3. Idiopathic: the cause is not known or understood.

Sign and symptoms/ clinical features

The symptoms depend on the age, volume of chyle, presence of underlying cause etc. Small chylothorax may not cause any symptoms but are only detected when a chest X-ray is performed. In the case of large chylothorax breathlessness is the earliest symptom noticed. The breathlessness is even present at rest. Patients will feel pressure on the side of the chylothorax. This pressure or tightness is felt due to the restriction of fluid that does not allow lungs to expand while breathing. But if the chyle deposition or accumulation has taken place slowly then lungs might build the capacity to get used to it. Fever and chest pain are generally not the signs present in this case due to the absence of any inflammation.

When we auscultate, low breathing sounds on the affected side are noticed. It is also associated with a dull sound on percussion. Large chylothorax can cause malnutrition, low immunity, drop in blood volumes and also low blood pressure.

Types of chylothorax

1. Traumatic chylothorax

This type of chylothorax is usually the complication of the surgery associated with thorax, heart and esophagus. It is the most common complication of pneumonectomy and also of the surgeries that require mediastinal dissection. After pacemaker implantation, embolization of pulmonary arteriovenous malformation, chyle accumulation around lungs is commonly noticed these days. Even after the blunt trauma to the chest region and also blast injuries are responsible for causing chylothorax. Surprisingly small injuries due to sneezing and coughing causes chylothorax.

2. Non traumatic chylothorax

This type includes malignancies commonly. Lung cancer, kaposi sarcoma, secondary lung cancer,esophageal cancer are the commonest causes of non traumatic chylothorax. Sometimes in the rarest cases this condition can be associated with the congenital lymphatic system malformations. In both the cases whether traumatic or non traumatic there is obstruction or destruction of the thoracic duct that causes chylothorax.

Mechanism

The main mechanism of chylothorax includes the leaking of chyle from the thoracic duct due to the disturbance affecting the structural integrity of this duct. Any disturbance will cause pressure in the thoracic duct to raise and also in the collateral channels that ultimately drain into the thorax. Trauma to the thoracic duct is the most common cause of chylothorax. Moreover the involvement of the side is decided on which level the duct is injured. Like if the duct is injured above the level of 5th thoracic vertebrae then the left side will be involved but if the duct is injured below the level of 5th vertebrae then the right side is involved. Generally the right side is involved.

Diagnosis

Most commonly chylothorax is diagnosed through X-ray. It appears as a dense, homogenous area that behaves as an obstruction for costophrenic and cardiophrenic angles. In some cases fluid samples can also be taken from the chest and serological study is done to confirm malignancy.

Treatment

Usually the primary cause is to be treated first. If the condition is the result of duct leakage after surgery then ligation of the thoracic duct is done (by performing one more surgery). In case of non traumatic conditions the primary cause is to be diagnosed by observing the patient and performing certain tests that should include chyle aspiration and serological study. If we talk about conservative treatment then it includes thoracentesis and indwelling catheter use.

As per Ayurveda

In ayurveda it can be understood as a pranavaha srotas vyadhi. The main causes that are told by acharya charaka are as follows

1. Dhatu Kshaya
2. Vega dharan (Controlling urges)
3. Ruksha sevan ahara
4. Exercising when you are feeling hungry
5. Doing work more than capacity.

(ch. Viman. 5/10)

Acharayas mentioned vamana, nasya, dhoomapana, snehana, swedana and virechana therapy as the treatment in pranavaha srotas vyadhi. They also mentioned some medication for formulations like shwas kuthar rasa, trikatu churna, vasa ghrita and many more for the management of pranavaha srotas conditions.

Herbal Remedies by Planet Ayurveda

Planet Ayurveda also offers some of its formulations that are very useful in managing conditions like chylothorax. These Medications are totally herbal and cause no side effects. The medications or formulations offered are as follows

1. Praanrakshak churna
2. Vasaka capsules
3. Curcumin capsules
4. Tulsi capsules
5. Giloy capsules

Products Description

1. Praanrakshak churna

This herbal formulation contains vaasa (Adhatoda vasica), kantkari (Solanum xanthocarpum), mulethi (Glycyrrhiza glabra) and many more. It is very very beneficial in chronic allergies, respiratory infections and respiratory problems like pneumonia. It helps in pacifying kapha and reduces breathlessness in chylothorax.

Dose: One Teaspoon twice a day after meals.

2. Vasaka capsules

The formulation is a single herb formulation that contains Adhatoda vasica. Vasaka helps in pacifying kapha, reduces the breathlessness by clearing bronchial spaces.

Dose: One capsule twice a day after meals.

3. Curcumin capsules

Curcuma longa or curcumin (haridra) is an effective herb that helps in preventing and managing respiratory infections. It also helps in removing accumulated toxins by acting as an antioxidant. It has an antiseptic nature and purifies blood.

Dose: One capsule twice a day after meals.

4. Tulsi capsules

Tulsi (Ocimum sanctum) is a herb that is known from ages for its antimicrobial properties. It also has antifungal, antiseptic and anticancer properties. It is very useful in patients with chylothorax due to associated cancerous conditions.

Dose: One capsule twice a day after meals.

5. Giloy capsules

This herb has antipyretic and anti inflammatory properties. It helps in building a strong immune system. In chylothorax, if a person suffers from compromised immunity due to excessive amount of chyle then this herb can behave as a blessing.

Dose: One capsule twice a day after meals.

Contact my assistant to provide you the costing / ordering and delivery information at – costing.planetayurveda@gmail.com or call at +91-172-5214030 Or Check Website – www.PlanetAyurveda.com

Conclusion

Chylothorax is a rare condition, if it develops it is very difficult to manage it without surgery. Moreover it is having a typical nature of causing no symptoms while in small amounts makes it more difficult to diagnose it. The herbal formulations offered by planet ayurveda are very effective in managing this condition without causing any kind of side effects. In case of any query kindly visit www.PlanetAyurveda.com