Intended for healthcare professionals


The mystery of the milky effusion

BMJ 2005; 330 doi: (Published 10 March 2005) Cite this as: BMJ 2005;330:575
  1. Rajnish Duara, resident (
  1. department of cardiovascular and thoracic surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India

A 59 year old man was admitted to our cardiac surgical intensive care unit after a third operation on the mitral and aortic valves. His previous operations had been six months before. All three surgeries were done via a median sternotomy, and the left pleural space was never opened during the operations.

The postoperative recovery was initially uneventful. The day after surgery the patient was extubated, and the chest drains removed. The next day, however, we noticed a reduced air entry in the left lower zone of the chest, and a chest x ray showed some haziness in the left lower zone, consistent with a collection of fluid in the left pleural space. …

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