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Use of an Alpha-1 Adrenoreceptor Agonist in the Management of Recurrent Refractory Idiopathic Chylothorax  Parthipan Sivakumar, BM, Liju Ahmed, MBBS 

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1 Use of an Alpha-1 Adrenoreceptor Agonist in the Management of Recurrent Refractory Idiopathic Chylothorax  Parthipan Sivakumar, BM, Liju Ahmed, MBBS  CHEST  Volume 154, Issue 1, Pages e1-e4 (July 2018) DOI: /j.chest Copyright © 2018 American College of Chest Physicians Terms and Conditions

2 Figure 1 A, Chest radiograph during the initial admission with right-sided pleural effusion. B, Chest radiograph on discharge from initial admission. CHEST  , e1-e4DOI: ( /j.chest ) Copyright © 2018 American College of Chest Physicians Terms and Conditions

3 Figure 2 Views at thoracoscopic surgery—the cisterna chyli herniating through the diaphragm. CHEST  , e1-e4DOI: ( /j.chest ) Copyright © 2018 American College of Chest Physicians Terms and Conditions

4 Figure 3 A, After repeat presentation with breathlessness. Chest radiograph shows presence of bilateral pleural effusions, with the left greater than the right. B, Postthoracoscopy and iodine pleurodesis. Left-sided chest drain in situ. Locules of effusion are indicated by arrows. C, Postdischarge after 1 week of midodrine therapy. The right-sided fluid locule has cleared. D, After 3 weeks of midodrine therapy. Chest radiograph shows improvement in appearances with regression in the left-sided locules of pleural fluid. E, Two weeks postcessation of midodrine. F, Chest radiograph at 6-month follow-up. CHEST  , e1-e4DOI: ( /j.chest ) Copyright © 2018 American College of Chest Physicians Terms and Conditions


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