Post-op of a thoraco-abdominal aorta aneurysm repair.
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There is a moderate left pleural effusions of water density (around 11 HU), which is a non specific finding in this post-op patient. However, the effusion is strangely wavy instead of having the usual crescent shape. This does not necessarily correlate with chylothorax, but it makes us more suspicious of the diagnosis in the context of a possible per-operative thoracic duct laceration.
Chylothorax is suspected on clinical grounds, as in this patient. Pleural puncture and pleural fluid analysis confirmed the diagnosis.