Chylothorax is a condition characterized by the accumulation of chyle in the pleural space, diagnosed when pleural fluid shows triglyceride levels greater than 1.24 mmol/L and the presence of chylomicrons, giving it a milky white appearance. It can be subdivided into exudative or transudative, the latter of which is an infrequent manifestation and in current literature has only been cited in case reports. Here, we present the case of a 79-year-old male with a history of alcoholic liver cirrhosis, type 2 diabetes mellitus, chronic kidney disease stage 3a and hypertension who presented with a right-sided pleural effusion and minimal abdominal ascites. A thoracentesis and abdominal paracentesis were performed, and fluid analyses demonstrated a transudative chylothorax with concomitant non-chylous ascites. In this review, we aim to highlight the rarity of this condition and discuss the pathogenesis and management.
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