Yellow nail syndrome (YNS) is a rare condition characterized by the triad of yellow nails,
lymphedema, and respiratory manifestations.
Diuretics and thoracic drainage are often not effective in YNS, and the most effective treatments are
pleurodesis and decortication/pleurectomy. A 66-year-old man was admitted to our hospital for YNS after
esophagectomy with gastric tube reconstruction for
esophageal cancer. The patient presented with yellow nails and
lymphedema. Chest X-rays and computed tomography showed massive
pleural effusions and
ascites that were both chylous. The patient was considered to have YNS that became apparent after surgery. He recovered with
diuretics and a
low-fat diet without
pleurodesis and decortication/pleurectomy. Thoracic surgery can exacerbate the functional impairment of lymphatic drainage in patients with asymptomatic and undiagnosed YNS, and can lead to further development of YNS-related clinical symptoms. Despite relatively massive
chylothorax following thoracic surgery,
chylothorax related to YNS could be successfully controlled with
conservative treatment without
pleurodesis and decortication/pleurectomy.