Grant P W, Brown S W
Cardiothoracic Department, Waikato Hospital, Hamilton, New Zealand.
Aust N Z J Surg. 1991 Oct;61(10):798-800.
A case of traumatic chylothorax following a motor vehicle accident is presented. This is a rare injury following thoracic trauma and is associated with a high mortality and morbidity. Mechanisms of injury to the thoracic duct are described. A management strategy is suggested, which initially entails a trial of conservative therapy of adequate drainage, total parenteral nutrition (TPN) and total gut rest. If significant chyle losses persist after 2 weeks, surgery is indicated, as immunological factors may complicate recovery. The recommended surgical technique is transthoracic duct ligation directly or at the hiatus.
本文报告一例机动车事故后发生的创伤性乳糜胸病例。这是胸部创伤后一种罕见的损伤，与高死亡率和高发病率相关。文中描述了胸导管的损伤机制。建议了一种管理策略，最初需要进行充分引流、全胃肠外营养（TPN）和完全肠道休息的保守治疗试验。如果2周后仍持续有大量乳糜丢失，则需进行手术，因为免疫因素可能使恢复复杂化。推荐的手术技术是直接经胸结扎胸导管或在裂孔处结扎。
