Abstract
Chylothorax is known for its rarity, and its diagnosis following blunt chest trauma is exceptional. Only a small number of cases have been reported in the literature. Severe consequences, such as cardiopulmonary abnormalities and metabolic, nutritional, and immunologic disorders, can result from chylothorax. Management of chylothorax is challenging. It can either be managed nonoperatively or surgically. Surgical treatment is required in cases of persistent or high output fistulae. We report here in three cases of blunt trauma chest following road traffic crash associated with chylothorax. All of them were successfully managed nonoperatively with inter costal tube drainage and supportive treatment sans need of any operative intervention.
References
Talwar A, Lee HJ (2008) A contemporary review of chylothorax. Indian J Chest Dis Allied Sci 50(4):343–351
Watts SH (1921) Traumatic chylothorax. Ann Surg 74(6):691–696
Brook MP, Dupree DW (1988) Bilateral traumatic chylothorax. Ann Emerg Med 19:69–72
Bessone LN, Ferguson TB, Burford TH (1971) Chylothorax. Ann Thorac Surg 12:527–550
Meurer MF, Cohen DJ (1990) Current treatment of chylothorax: a cases series and literature review. J Tex Med 86:82–85
Cevese PG, Vecchioni R, D’Amico DF et al (1975) Postoperative chylothorax: six cases in 2500 operations with surgery of the world literature. J Thorac Cardiovasc Surg 89:966–971
Grant PW, Brown SW (1991) Traumatic chylothorax: a case report. Aust NZJ Surg 61:789–800
Ferguson MK, Little AG, Skinner DB (1985) Current concepts in the management of postoperative chylothorax. Ann Thorac Surg 40:542–545
Patterson GA, Todd TR, Delarue NC, IIves R, Pearson FG, Cooper JD (1981) Supradiaphragmatic ligation of the thoracic duct in intractable chylous fistula. Ann Thorac Surg 32:44–49
Dulchavsky SA, Ledgerwood AM, Lucas CE (1988) Management of chylothorax after blunt chest trauma. J Trauma 28:1400–1401
Milano S, Maroldi R, Vezzoli G, Bozzola G, Battaglia G, Mombelloni G (1994) Chylothorax after blunt chest trauma. A unusual case with a long latent period. Thorac Cardiovasc Surg 42:187–190
Forster E, Le Maguet A, Cinqualbre J, Piombini JL, Schiltz E (1975) A case of chylothorax consecutive to a closed vertebro-costal trauma. Chirurgie 101:605–616
Markham KM, Glover JL, Welsh RJ, Lucas RJ, Bendick PJ (2000) Octreotide in the treatment of thoracic duct injuries. Am Surg 66:1165–1167
Mikroulis D, Didilis V, Bitzikas G, Bougioukaws G (2002) Octreotide in the treatment of chylothorax. Chest 121:2079–2080
Selle JG, Snyder WH, Schreiher JT (1973) Chylothorax: indications for surgery. Ann Surg 177:245–249
Kumar S, Kumar A, Pawar DK (2004) Thoracoscopic management of thoracic duct injury: is there a place for conservatism? JPGM 50:57–59
Conflict of Interest
No financial grant has been received for this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kumar, S., Mishra, B., Krishna, A. et al. Nonoperative Management of Traumatic Chylothorax. Indian J Surg 75 (Suppl 1), 465–468 (2013). https://doi.org/10.1007/s12262-012-0798-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-012-0798-8