A 63 year old female patient presented with dyspnoea and bilateral pleural effusions on the third day after excision of a left C8 neurinoma in proximity to the vertebral artery. The supraclavicular approach to the proximal vertebral artery required identification and ligation of the thoracic duct near its termination at the subclavian vein (A). Diagnostic and therapeutic pleural drainage (B) revealed abundant opalescent fluid. Bilateral chylothorax is an exceedingly rare complication that vascular surgeons should be aware of, possibly resulting from acute increase in lymphatic hydrostatic pressure. Conservative management with one week of parenteral nutrition ensured benign resolution of the condition.
