Persistent chylothorax. Treatment by talc pleurodesis.

Two patients with persistent chylothorax resistant to therapy by special diet, thoracenteses, and tube thoracostomy drainage were successfully treated by talc pleurodesis. In one patient with advanced lymphosarcoma involving pleura and mediastinal nodes, the chylothorax was managed by open thoracotomy and talc powder. The other patient developed chylothorax following resection of a thoracic aortic aneurysm. She was successfully treated by talc suspension introduced through a thoracostomy tube. Pleurodesis with talc should be considered only when the chylothorax persists after an adequate period of medical treatment and pleural decompression. Intrapleural instillation of talc through a thoracostomy tube should be successful if the chylothorax can be evacuated and the underlying lung fully expanded.