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Conservative management of traumatic chylothorax: a case report

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A case is presented of a right traumatic chylothorax, secondary to thoracic trauma with bilateral posterior eleventh rib fracture, treated by total parenteral nutrition and pleural drainage, with resolution within 2 weeks. On the basis of this clinical report and of a review of the literature, it is concluded that adequate conservative management should be initially the treatment of choice. Surgical treatment should be reserved to the cases in which clinical improvement does not occur within 2 weeks, and should consist of supradiaphragmatic thoracic duct ligation. Thoracoscopic fibrin glue injection has recently been described as a possible alternative treatment.

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  1. Teba L, Dedhia HV, Bowen R, Alexander JC (1985) Chylothorax review. Crit Care Med 13:49–52

    Google Scholar 

  2. Ferguson MK, Little AG, Skinner DB (1985) Current concepts in the management of postoperative chylothorax. Ann Thorac Surg 40:542–545

    Google Scholar 

  3. Milsom JW, Kron IL, Rheuban KS, Rodgers BM (1985) Chylothorax: an assessment of current surgical management. J Thorac Candiovasc Surg 89:221–227

    Google Scholar 

  4. Bolger C, Walsh TN, Tanner WA, Keeling P, Hennessy TPJ (1991) Chylothorax after oesophagectomy. Br J Surg 78:587–588

    Google Scholar 

  5. Ramzy AI, Rodriguez A, Cowley RA (1982) Pittfalls in the management of traumatic chylothorax. J Trauma 22:513–515

    Google Scholar 

  6. Grant P, Brown S (1991) Traumatic chylothorax: a case report. Aust NZ J Surg 61:798–800

    Google Scholar 

  7. Ramos W, Faintuch J (1986) Nutritional management of thoracic duct fistulas. A comparative study of parenteral versus enteral nutrition. J Parenter Enteral Nutrition 10:519–521

    Google Scholar 

  8. Patterson GA, Todd TRJ, Delarue NC, Ilves R, Pearson FG, Cooper JD (1980) Supradiaphragmatic ligation of the thoracic duct in intractable chylous fistula. Ann Thorac Surg 32:44–49

    Google Scholar 

  9. Starzl TE, Weil R, Koep LJ et al (1979) Thoracic duct drainage before and after cadaveric kidney transplantation. Surg Gynecol Obstet 149:815–819

    Google Scholar 

  10. Shirai T, Amano J, Takebe K (1991) Thoracoscopic diagnosis and treatment of chylothorax after pneumonectomy. Ann Thorac Surg 52:306–307

    Google Scholar 

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Fogli, L., Gorini, P. & Belcastro, S. Conservative management of traumatic chylothorax: a case report. Intensive Care Med 19, 176–177 (1993).

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