Delayed Chylothorax Following Blunt Chest Trauma

作者：Schurz Mark^*; Petras Nina; Platzer Patrick; Hofbauer Friedrich; Vecsei Vilmos

来源：European Journal of Trauma and Emergency Surgery, 2010, 36(1): 76-80.

DOI：10.1007/s00068-009-8127-z

• Chylothorax
• Blunt chest trauma
• Bilateral serial rib fracture
• Thoracovertebral fracture

Chylothorax is a very rare disease, and its diagnosis following blunt chest trauma is exceptional. Only a small number of cases have been reported in the literature. We report a case of a male patient involved in a car accident presenting a delayed chylothorax after blunt chest trauma with a bilateral serial rib fracture and fracture of the ninth thoracic vertebrae. The therapy includes thorax drainage, dietary modifications with total parenteral nutrition and, in severe cases, PEEP ventilation. Hematological monitoring is mandatory to detect metabolic abnormalities resulting from chyle loss. Surgical treatment is only required in cases of persistent or increasing intrathoracal chyle flow. Thoracoscopic ligation of the thoracic duct is then required.
Severe consequences, such as cardiopulmonary abnormalities and metabolic, nutritional and immunologic disorders, can result from chylothorax. Our patient was treated successfully by chest drainage and parenteral nutrition.

• 出版日期2010-2