Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA, USA.
Am J Phys Med Rehabil. 2012 Dec;91(12):1086-90. doi: 10.1097/PHM.0b013e31825f14c2.
After malignancy, traumatic and surgical injuries to the upper abdomen and chest are the leading causes of chylothorax. Thoracic spine extension injury, blunt or penetrating chest trauma, anterior thoracic spine surgery, and increased intra-abdominal pressure have all been implicated in the development of chylothorax. Despite the physiatrist's frequent exposure to polytrauma and postsurgical patients, there are no case reports of chylothorax complicating inpatient rehabilitation or occurring in a patient fitted in a thoracic or lumbar orthosis. We present the case of a patient with traumatic spinal cord injury from a high-speed motor vehicle accident who was diagnosed with a left-sided chylothorax while wearing a thoracolumbosacral orthosis 4 wks into her inpatient rehabilitation stay. Knowledge of the anatomy of the thoracic duct can be useful for diagnosing chylothorax in patients with thoracic spine fractures, upper abdomen/chest injury, or thoracic surgery, as the trajectory of the duct often determines the location of pleural effusion.
在恶性肿瘤、上腹部和胸部创伤和外科损伤之后，乳糜胸是主要原因。胸脊柱伸展损伤、钝性或穿透性胸部创伤、前胸脊柱手术以及腹内压增高都与乳糜胸的发展有关。尽管物理治疗师经常接触多发伤和手术后的患者，但没有乳糜胸合并住院康复或发生在佩戴胸腰椎矫形器的患者的病例报告。我们报告了一例因高速汽车事故导致的创伤性脊髓损伤患者的病例，该患者在住院康复 4 周时佩戴胸腰骶椎矫形器时被诊断为左侧乳糜胸。了解胸导管的解剖结构对于诊断胸脊柱骨折、上腹部/胸部损伤或胸外科手术患者的乳糜胸很有用，因为导管的轨迹通常决定胸腔积液的位置。
