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腹部经肝枪伤后出现难治性乳糜胸，需采用非常规手术治疗。

Refractory chylothorax following a transhepatic gunshot wound to the abdomen requiring unorthodox surgical treatment.

作者信息

Cestero Joseph, Bukhary Hassan, Carrillo Eddy, Rosenthal Hassan, Pepe Antonio, Sanchez Rafael, Lee Seong K

机构信息

Memorial Regional Hospital, Florida, USA.

出版信息

J Surg Case Rep. 2010 Aug 1;2010(6):3. doi: 10.1093/jscr/2010.6.3.

DOI:10.1093/jscr/2010.6.3
PMID:24946329
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3649136/
Abstract

An 18 year-old-male sustained a gunshot wound to the abdomen which required an uneventful hepatorrhaphy. He later returned with a large right effusion and was diagnosed with a chylothorax. The output was persistent despite conservative measures. Thoracotomy with attempted thoracic duct ligation was unsuccessful at decreasing the output. Re-exploration and ligation of the thoracic duct was required thru an abdominal approach.

摘要

一名18岁男性腹部遭受枪伤，接受了顺利的肝脏缝合术。他后来因右侧大量积液复诊，被诊断为乳糜胸。尽管采取了保守治疗措施，积液仍持续存在。尝试进行胸导管结扎的开胸手术未能减少积液量。需要通过腹部切口再次探查并结扎胸导管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/afaf345b549a/jscr-2010-6-3fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/02cdff7a4029/jscr-2010-6-3fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/af7d02a2ff99/jscr-2010-6-3fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/a3013e75b004/jscr-2010-6-3fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/f2fe70feefc2/jscr-2010-6-3fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/afaf345b549a/jscr-2010-6-3fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/02cdff7a4029/jscr-2010-6-3fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/af7d02a2ff99/jscr-2010-6-3fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/a3013e75b004/jscr-2010-6-3fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/f2fe70feefc2/jscr-2010-6-3fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b9/3649136/afaf345b549a/jscr-2010-6-3fig5.jpg

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本文引用的文献

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J Card Surg. 2009 Mar-Apr;24(2):220-2. doi: 10.1111/j.1540-8191.2009.00828.x.
2
Transabdominal ligation of the thoracic duct as treatment of choice for postoperative chylothorax after esophagectomy.经腹结扎胸导管作为食管癌切除术后乳糜胸的首选治疗方法。
Dis Esophagus. 2007;20(1):19-23. doi: 10.1111/j.1442-2050.2007.00636.x.
3
Combined late diagnosed right main bronchial disruption and chylothorax from blunt chest trauma.
迟发性诊断的钝性胸部创伤合并右主支气管断裂和乳糜胸
Ann Thorac Surg. 2004 Oct;78(4):e61-2. doi: 10.1016/j.athoracsur.2003.08.070.