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Successful management of post-esophagectomy chylothorax/chyloperitoneum by etilefrine.

Post-operative chylothorax and chyloperitoneum resulting from a thoracic duct injury are possible complications of esophagectomy for carcinoma. Management of such conditions includes conservative methods (pleural drainage, chyle flow reduction and supportive nutrition) and surgery. Etilefrine, a sympathomimetic drug used in the management of postural hypotension, also causes smooth muscle contraction of the thoracic duct. We successfully treated three patients with post-esophagectomy chylothorax and chyloperitoneum using intravenous etilefrine. Etilefrine infusion allowed chyle flow resolution in a few days without any side-effects. As result of this experience, we believe that etilefrine deserves to be considered as an alternative therapy in the management of post-esophagectomy chylothorax/chyloperitoneum.

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