Department of Surgery, Division of Trauma and Surgical Critical Care, Kern Medical Center, Bakersfield, California.
Department of Nutrition and Dietary Services, Kern Medical Center, Bakersfield, California.
World J Emerg Surg. 2011 Mar 28;6:10. doi: 10.1186/1749-7922-6-10.
Chylothorax is a rare form of pleural effusion that can be associated with both traumatic and non-traumatic causes. Thoracic duct ligation is often the treatment of choice in postsurgical patients; however the optimal treatment of this disease process after traumatic injury remains unclear 1. We present a rare case of a thoracic duct injury secondary to a blunt thoracic spine fracture and subluxation which was successfully treated non-operatively.
A 51 year old male presented as a tier one trauma code due to an automobile versus bicycle collision. His examination and radiographic work-up revealed fractures and a subluxation at the third and fourth thoracic spine levels resulting in paraplegia. He also sustained bilateral hemothoraces secondary to multiple rib fractures. Drainage of the left hemothorax led to the diagnosis of a traumatic chylothorax. The thoracic spine fractures were addressed with surgical stabilization and the chylothorax was successfully treated with drainage and dietary manipulation.
This unusual and complex blunt thoracic duct injury required a multidisciplinary approach. Although the spine injury required surgical fixation, successful resolution of the chyle leak was achieved without surgical intervention.
乳糜胸是一种罕见的胸腔积液形式，可与创伤和非创伤原因有关。胸导管结扎通常是手术后患者的首选治疗方法；然而，创伤后这种疾病过程的最佳治疗方法仍不清楚 1。我们报告了一例继发于钝性胸椎骨折和半脱位的胸导管损伤的罕见病例，该病例经非手术治疗成功治愈。
一名 51 岁男性因汽车与自行车碰撞而被列为一级创伤患者。他的检查和影像学检查显示第三和第四胸椎水平的骨折和半脱位导致截瘫。他还因多发性肋骨骨折而导致双侧血胸。左侧血胸引流导致外伤性乳糜胸的诊断。胸椎骨折采用手术固定，乳糜胸通过引流和饮食管理成功治疗。
这种不常见且复杂的钝性胸导管损伤需要多学科方法。尽管脊柱损伤需要手术固定，但无需手术干预即可成功解决乳糜漏。
