Chylothorax Following Endoscopic Ultrasound‐Guided Fine‐Needle Aspiration: A Rare Complication and Its Anatomical Risk Factors
Saima Bandarkar, Ahmed Abdelsamad, Yousef Aleid, Ahmed Nasr, Talal AlSaeed, Essa AlGunaim, Derar AlShehab, Adel Ayed, Mohammed I. Ghanbar, Sulaiman KhadadahABSTRACT
Chylothorax is an exceptionally rare complication of endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA), with only a limited number of cases reported in the literature. We present the case of a 66‐year‐old man who presented with dyspnoea 3 days after EUS‐FNA of a paraoesophageal left upper lobe lung mass. Chest radiography and CT demonstrated a left‐sided pleural effusion, and image‐guided pleural drainage yielded milky fluid whose analysis confirmed chylothorax. He was managed conservatively with a 14‐French intercostal chest drain (ICD), dietary modification and octreotide therapy, achieving complete clinical recovery. This case underscores the delayed and potentially under‐recognised presentation of post‐EUS‐FNA chylothorax and raises the possibility that anatomical relationships between thoracic lesions and the thoracic duct may represent a potential risk factor for this uncommon complication.